MedWorm: National Institute for Health and Clinical Excellence (NICE)

NICE gives final guidance on apixaban for VTE

PharmacoEconomics and Outcomes News — Thu, 09 Feb 2012 14:54:20 +0100

(Source: PharmacoEconomics and Outcomes News)

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Sunitinib Malate in the Treatment of Metastatic Renal Cell Carcinoma: the North of England Cancer Network (NECN) Experience

Clinical Oncology — Thu, 09 Feb 2012 08:13:42 +0100

Introduction: Metastatic renal cell carcinoma (mRCC) has a poor prognosis. Treatment aims to improve progression free survival (PFS) and overall survival (OS). Sunitinib gained NICE approval in March 2009 as first line treatment and experience with it is growing. The NECN was the first in the UK to approve the use of Sunitinib in July 2007. This retrospective re-audit compares the NECN patient outcomes with published literature, updating previous NECN work from 2008. (Source: Clinical Oncology)

Analysis of Malignant Spinal Cord Compression Patients treated in a Regional Neuro-oncology Centre

Clinical Oncology — Thu, 09 Feb 2012 08:13:42 +0100

Introduction: Since December 2009 there has been a spinal cord compression coordinator in the Lancashire and Cumbria cancer network to enable patients to receive care as per NICE 2008 guidelines [1]. We conducted a retrospective analysis of patient management between December 2009 and January 2011 and reviewed survival outcomes. (Source: Clinical Oncology)

Not to Be Antisocial, But—Why Don’t You Leave Me Alone? Part I

Psychology Today Personality Center — Wed, 08 Feb 2012 23:31:22 +0100

Have you ever felt deluged by invitations, festivities, celebrations, get-togethers, gatherings, blasts, soirees, shindigs, and Super Bowl tail-gates, when all you wanted to do was spend a nice quiet evening with your dog and the Internet?read more (Source: Psychology Today Personality Center)

TV review: Super Smart Animals; Roger & Val Have Just Got In

Guardian Unlimited Science — Wed, 08 Feb 2012 22:30:00 +0100

If you think Tillman the skateboarding bulldog is clever, take a look at this lotAh yes, Tillman the skateboarding bulldog from Venice Beach, Los Angeles. I think I may know Tillman from YouTube. He scoots along, left legs on the board, right legs kicking the ground, gaining momentum, then on he hops and he's off, leaning into corners, tongue hanging out, clearly loving it. A bit too clearly, perhaps – you may want to work on your indifference, Tillman, your skater cool. Otherwise, good job.This is not a trick he's been taught; he's not getting any treats for doing it. Tillman skateboards because he loves skateboarding. He's here, on Super Smart Animals (BBC1), to demonstrate not just his prowess but also that animals are capable of learning simply through having the enthusiasm to try th...

NICE to develop formulary rules 'to tackle drug postcode lottery'

HealthcareRepublic Pharmacist News — Wed, 08 Feb 2012 14:25:00 +0100

A best-practice guide to establishing local formularies will aim to tackle the postcode lottery faced by patients trying to access NHS drugs. (Source: HealthcareRepublic Pharmacist News)

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London Cancer New Drugs Group Rapid Review:Erlotinib for the first-line treatment of advanced NSCLC with EGFR mutation

NeLM - Drug Specific Reviews — Wed, 08 Feb 2012 05:00:00 +0100

Source: London Cancer New Drugs Group Area: Evidence > Drug Specific Reviews Current NICE-approved first-line treatments for patients with NSCLC who have EGFR activating mutations include platinum-doublet chemotherapy (mainly gemcitabine plus cisplatin or carboplatin in the UK), gefitinib, and pemetrexed plus cisplatin (for adenocarcinoma or large-cell carcinoma only). Erlotinib has recently had its license extended to include the first-line treatment of patients with locally advanced or metastatic NSCLC with EGFR activating mutations. In the European registration Phase III study (EURTAC), erlotinib at a dose of 150mg daily continued until disease progression (or unacceptable toxicity) resulted in a PFS gain of 4.5 months compared to standard chemotherapy; survi...

NHS Evidence Update: Reducing the risk of VTE

NeLM - News — Wed, 08 Feb 2012 05:00:00 +0100

Source: NHS Evidence Area: News This latest update identifies new evidence relevant AND SUBSEQUENT TO to NICE clinical guideline 92 'Reducing the risk of venous thromboembolism (VTE) in patients admitted to hospital' (published 2010) that might generate future change to the practice laid out in the guidance. Key messages pertaining to newly published evidence include the following: . Evidence appears to confirm that thalidomide in patients with multiple myeloma (MM) may increase the risk of venous thromboembolism (VTE), and evidence now also suggests an elevated risk with lenalidomide in this population. . The most effective thromboprophylaxis in patients receiving thalidomide or lenalidomide for MM does not yet appear to have been established by curr...

Cost-effectiveness of bivalirudin versus heparin plus glycoprotein IIb/IIIa inhibitor for acute MI in the UK

NeLM - News — Wed, 08 Feb 2012 05:00:00 +0100

Source: Heart Area: News This model-based cost-utility analysis assessed the cost-effectiveness of bivalirudin versus heparin and glycoprotein IIb/IIIa inhibitor (H-GPI) in patients undergoing primary percutaneous coronary intervention (PPCI) for acute ST-segment elevation myocardial infarction (STEMI), and was provided for the NICE appraisal of bivalirudin use in STEMI patients undergoing PPCI. The model evaluated incremental costs, and incremental clinical effectiveness expressed as quality-adjusted life-years (QALYs) gained. The following findings were reported: . The main model (clinical events until the end of year 1) predicted bivalirudin and H-GPI patients to survive 11.52 and 11.35 (undiscounted) years on average, respectively, and to accrue 6.26 and 6...

NPC publishes sixth issue of 'tough decisions

NeLM - News — Wed, 08 Feb 2012 05:00:00 +0100

Source: NPC Area: News The National Prescribing Centre (NPC) has published the sixth edition of its newsletter 'Tough Decisions', a quarterly publication available to all NHS personnel making decisions about the funding and commissioning of medicines at a local level. This issue addresses the following topics: . Local decision-making news.in brief . How the NPC and NICE can help you and your commissioning groups . New medicines - are you prepared? . Managing medicines across a health community - is your Area Prescribing Committee fit for purpose? . IFR manager newsSharing practice The newsletter can be accessed at the link below. (Source: NeLM - News)

When a Physician Lives Where She Works, Sometimes Worlds Collide

Physicians Practice — Tue, 07 Feb 2012 15:30:02 +0100

The convenience of practicing medicine in the same town you live is nice, but I’d like a little more separation between my life as a doctor and my personal life. (Source: Physicians Practice)

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New findings highlight the benefit of exercise electrocardiograms (ECGs) just as they are being scrapped

University of Bristol news — Tue, 07 Feb 2012 08:00:00 +0100

In the UK, the exercise electrocardiogram (ECG) is the most common initial test for the evaluation of stable chest pain and has been used widely for almost half a century. However, recent NICE guidelines recommend that it should not be used to diagnose or exclude stable angina in patient assessments. New research published in the BMJ Open finds that the test has other uses that transcend its technical contribution to diagnosis. (Source: University of Bristol news)

London Cancer New Drugs Group Rapid Review: SIRT WITH YTTRIUM-90 MICROSPHERES FOR THE THIRD LINE TREATMENT OF LIVER METASTASES FROM COLORECTAL CANCER

NeLM - Drug Specific Reviews — Tue, 07 Feb 2012 05:00:00 +0100

Source: London Cancer New Drugs Group Area: Evidence > Drug Specific Reviews Selective internal radiation therapy (SIRT; micro-brachytherapy or 'radio-embolisation') is used for the treatment of non-resectable hepatic metastases secondary to colorectal cancer, with limited or no extrahepatic disease. It may be used alone or in combination with chemotherapy. It aims to deliver radiation directly into the metastases, minimising the risk of radiation damage to healthy surrounding tissues. Under local anaesthesia, glass or resin microspheres containing a small radioactive source (yttrium-90) designed to embolise into small vessels around the metastases, are injected into branches of the hepatic artery (usually via a percutaneous femoral approach). In this way the microspheres can be selec...

London Cancer New Drugs Group Rapid Review: Lapatinib with capecitabine following disease progression on trastuzumab for metastatic breast cancer

NeLM - Drug Specific Reviews — Tue, 07 Feb 2012 05:00:00 +0100

Source: London Cancer New Drugs Group Area: Evidence > Drug Specific Reviews Lapatinib is licensed for the treatment of patients with breast cancer, whose tumours overexpress HER2 in combination with capecitabine for patients with advanced or metastatic disease with progression following prior therapy, which must have included anthracyclines and taxanes and therapy with trastuzumab in the metastatic setting. In May 2010, NICE issued a FAD which did not support this use of lapatinib in combination with capecitabine, except in the context of clinical trials, as it was not a cost-effective use of NHS resources, even taking into account the proposed patient access scheme. This FAD has now been withdrawn following an appeal from the manufacturers and because of the extension of the review ...

Valuing the economic benefits of complex interventions: when maximising health is not sufficient

Health Economics — Mon, 06 Feb 2012 14:42:10 +0100

ABSTRACTComplex interventions, involving interlinked packages of care, challenge the application of current methods of economic evaluation that focus on measuring only health gain. Complex interventions may be problematic on two levels. The complexity means the intervention may not fit into one of the current appraisal systems, and/or maximising health is not the only objective. This paper discusses the implications of a programme of work that focused on clinical genetics services, as an example of a complex intervention, and aimed to identify the following: the attributes that comprise both health and non‐health aspects of benefits and whether it is possible to evaluate such an intervention using current National Institute for Health and Clinical Excellence appraisal processes. Genetic ...

Iron therapy in patients with chronic kidney disease

Transfusion Alternatives in Transfusion Medicine — Sun, 05 Feb 2012 05:00:00 +0100

SUMMARYIron deficiency, both functional and absolute, is common in patients with chronic kidney disease and in those requiring dialysis. The Renal National Service Framework and National Institute for Health and Clinical Excellence advocate treatment of anemia in patients with chronic kidney disease. Oral iron is often both insufficient and slow to improve hemoglobin levels while intravenous supplementation replenishes and maintains iron stores more effectively. This leads to a reduction in the use of erythropoietin stimulating agents. This reduction in erythropoietin stimulating agents use may be potentially beneficial in certain cases in particularly reducing stroke risk. In contrast, intravenous iron has the potential to improve quality of life, reduce cardiovascular risk and produce co...

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Jab that ends the agony of childhood arthritis: New NHS treatment brings relief to nine in ten young patients

the Mail online | Health — Sat, 04 Feb 2012 22:08:50 +0100

NICE has approved RoActemra (tocilizumab) to treat systemic juvenile idiopathic arthritis (sJIA) which is currently incurable. (Source: the Mail online | Health)

Mystery bird: blue pitta, Hydrornis cyanea | @GrrlScientist

Guardian Unlimited Science — Sat, 04 Feb 2012 18:30:01 +0100

This southeast Asian mystery bird is atypical amongst those species with similar habits (includes gorgeous video!) Blue pitta, Hydrornis cyanea, (protonym, Pitta cyanea) Blyth, 1843, also known as the lesser blue pitta, photographed at the Phu Khieo Wildlife Sanctuary, Chaiyaphum, Thailand. Image: Alex Vargas, 10 January 2012 (with permission) [velociraptorize].Nikon D5000, Nikkor 300mm f/2.8G ED-IF AF-S VR 1/10s f/5.6 at 420.0mm iso500, With a Kenko 1.4X Teleconverter on. Question: This southeast Asian mystery bird is atypical amongst those species with similar habits. Can you tell me in what way it is atypical? Can you identify this mystery bird's taxonomic family and species? Response: Adult male blue pitta, Hydrornis cyanea, a medium-sized passerine that is placed into Pittidae. The pi...

[World Report] NICE epilepsy guidance “may be detrimental to patient care”

LANCET — Sat, 04 Feb 2012 05:00:00 +0100

New NICE guidelines on epilepsies have come under fire by several experts who say that they do not reflect clinical experience and focus too much on drug cost effectiveness. David Holmes reports. (Source: LANCET)

Jacqueline Rose: a life in writing

Guardian Unlimited Science — Fri, 03 Feb 2012 22:55:08 +0100

'Victimhood is something that happens but when you turn it into an identity you're psychically and politically finished'One day, Jacqueline Rose came across a troubling passage in Proust's A la recherche du temps perdu. The narrator, Marcel, lies beside his sleeping lover Albertine and masturbates against her. "It seemed to me at those moments," writes Proust in Carol Clark's recent Penguin translation, "that I possessed her more completely, like an unconscious part of dumb nature." Professor Rose, feminist and psychoanalytic critic, bristled. "I thought 'This is ridiculous – she'd have woken up by now!' I had my feminist reaction – which is not my most obvious default position – which is just let the woman speak."So Rose decided to awaken Proust's lover from her implausible slumber....

NICE to help improve access to NICE-approved drugs by developing a best practice guide to formulary development

NeLM - News — Fri, 03 Feb 2012 05:00:00 +0100

Source: NICE Area: News The National Institute for Health and Clinical Excellence (NICE) has announced that it is to produce a best practice guide to help trusts develop local formularies. The development of the guide is part of a move to ensure that all patients in England have access to clinically and cost-effective drugs. The press release from NICE notes that at present there is no standard process or advice for putting together a local formulary which has led to variations across the country. Additionally, a recent report into innovation from the Department of Health identified that not all local formularies are including all of NICE's technology appraisals, thus contributing to a postcode lottery. The report also outlines plans to introduce, within three months, a NICE Co...

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Draft NICE guidance says more evidence needed on new test to guide breast cancer treatment decisions

NeLM - News — Fri, 03 Feb 2012 05:00:00 +0100

Source: NICE Area: News NICE has published draft guidance from their Diagnostics Assessment Programme on four tests used to guide decisions about the use of chemotherapy in women with early breast cancer. The four tests evaluated in the draft guidance measure the presence of multiple markers within the tumour that may indicate how the tumour is likely to progress. Used in conjunction with other available information such as tumour size and grade, they aim to improve the targeting of chemotherapy in breast cancer by improving the stratification and identification of patients who are most likely to benefit from chemotherapy. The rationale is based on the knowledge that certain biological features of cancers may indicate an increased likelihood of rapid growth and metastatic potential. ...

Improving access to NICE approved drugs

NHS Networks — Fri, 03 Feb 2012 05:00:00 +0100

Local formularies provide a list of selected or preferred drugs available to local prescribers and have an important role in underpinning safe and effective use of medicines. However, there is currently no standard process or advice for putting together a local formulary which has led to variations across the country. A recent report into innovation in healthcare by the Department of Health has highlighted that not all local formularies are including all of NICE's technology appraisals. This can lead to a postcode lottery where patients miss out on drugs approved by NICE. (Source: NHS Networks)

Vitamin D status: sunshine is nice but other factors prevail

European Journal of Nutrition — Thu, 02 Feb 2012 17:57:42 +0100

Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00394-012-0315-7Authors Göran Toss, Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, 581 85 Linköping, SwedenPer Magnusson, Bone and Mineral Metabolic Unit, Division of Clinical Chemistry, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, 581 85 Linköping, Sweden Journal European Journal of NutritionOnline ISSN 1436-6215Print ISSN 1436-6207 (Source: European Journal of Nutrition)

NICE deem prostate cancer drug too expensive

Nursing Times Breaking News — Thu, 02 Feb 2012 09:50:00 +0100

A prostate cancer drug is too expensive for use on the NHS, a watchdog has ruled. (Source: Nursing Times Breaking News)

Abiraterone not recommended for prostate cancer

Pharmacy Europe — Thu, 02 Feb 2012 09:43:00 +0100

The UK's National Institute for Health and Clinical Excellence claims drug is too expensive (Source: Pharmacy Europe)

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Al Megrahi's prostate cancer drug 'too expensive' for NHS

Telegraph Health — Thu, 02 Feb 2012 06:30:00 +0100

The prostate cancer pill used to keep alive the Lockerbie bomber Ali Mohmed Al Megrahi has been turned down by the NHS's drug spending watchdog as too expensive. (Source: Telegraph Health)

NICE issues Appraisal Consultation Document on abiraterone for metastatic, castration resistant prostate cancer

NeLM - News — Thu, 02 Feb 2012 05:00:00 +0100

Source: NICE Area: News NICE has issued an Appraisal Consultation Document on abiraterone, an oral selective inhibitor of androgen biosynthesis which irreversibly blocks cytochrome P17 (an enzyme involved in the production of testosterone), thereby stopping androgen synthesis in the adrenals, prostate and the tumour. The Institute does not recommend abiraterone in combination with prednisone or prednisolone for the treatment of castration-resistant metastatic prostate cancer that has progressed on or after a docetaxel-containing regimen. (Source: NeLM - News)

UK says home-grown cancer pill too costly to use

Reuters: Health — Thu, 02 Feb 2012 00:10:14 +0100

LONDON (Reuters) - Britain's health cost watchdog NICE sparked a major row on Thursday by snubbing a pricey new prostate cancer pill discovered at the country's top cancer research centre, a decision critics said was bad for patients and research. (Source: Reuters: Health)

CCG performance could be measured against 120 indicators

HSJ — Wed, 01 Feb 2012 13:11:00 +0100

Clinical commissioning groups could be judged against up to 120 performance measures, the National Institute for Health and Clinical Excellence has revealed today. (Source: HSJ)

[News] NICE guidance on dasatinib, high-dose imatinib, and nilotinib for patients with CML who are resistant or intolerant to imatinib

The Lancet Oncology — Wed, 01 Feb 2012 05:00:00 +0100

On Jan 13, 2012, the UK National Institute for Health and Clinical Excellence (NICE) published guidance recommending nilotinib for the treatment of the chronic and accelerated phases of chronic myeloid leukaemia (CML) that is resistant or intolerant to standard-dose imatinib. Dasatinib, is not recommended for treatment of chronic, accelerated, or blast-crisis phase CML in adults with imatinib intolerance or whose CML is resistant to treatment with standard-dose imatinib. High-dose imatinib is not recommended for the treatment of chronic, accelerated, or blast-crisis phase Philadelphia-chromosome-positive CML that is resistant to standard-dose imatinib. (Source: The Lancet Oncology)

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[News] NICE guidance on rituximab for first-line treatment of symptomatic stage III–IV follicular lymphoma in previously untreated patients

The Lancet Oncology — Wed, 01 Feb 2012 05:00:00 +0100

On 25 Jan, 2012, the UK National Institute for Health and Clinical Excellence (NICE) published guidance recommending the use of rituximab in combination with certain chemotherapy regimens for the treatment of symptomatic stage III–IV follicular lymphoma in previously untreated patients. The chemotherapy regimens listed were: cyclophosphamide, vincristine, and prednisolone (CVP); cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP); mitoxantrone, chlorambucil, and prednisolone (MCP); cyclophosphamide, doxorubicin, etoposide, pred-nisolone and interferon α (CHVPi); and chlorambucil. (Source: The Lancet Oncology)

Who came up with the model for excessive pay? No, it wasn't the bankers – it was academics | Aditya Chakrabortty

Guardian Unlimited Science — Mon, 30 Jan 2012 20:30:01 +0100

All the focus has been on bankers' bonuses, yet no one has looked at the economists who argued for rewarding bosses by giving them a bigger financial stake in their companiesTake a big step back. Ignore those sterile debates about how Dave screwed up over Stephen Hester's pay and where this leaves Ed. Instead, ask this: which profession has done most to justify the millions handed over to the boss of RBS, his colleagues and counterparts? Which group has been most influential in making the argument that top people deserve top pay? Not the executives themselves – at least, not directly. Nor the headhunters. Try the economists.The ground rules for the system by which City bankers, Westminster MPs and ordinary taxpayers live today were set by two US economists just a couple of decades ago. I...

Is there any scientific evidence for the use of glucosamine in the management of human osteoarthritis?

Arthritis Research and Therapy — Mon, 30 Jan 2012 05:00:00 +0100

Glucosamine in its acetylated form is a natural constituent of some glycosaminoglycans (e.g. hyaluronic acid and keratan sulfate) in the proteoglycans found in articular cartilage, intervertebral disc and synovial fluid. Glucosamine can be extracted and stabilized by chemical modification and used as a drug or a nutraceutical. It has been approved for the treatment of osteoarthritis (OA) in Europe to promote cartilage and joint health and is sold over the counter as a dietary supplement in the United States. Various formulations of glucosamine have been tested including glucosamine sulfate and glucosamine hydrochloride. In vitro and in vivo studies have uncovered glucosamine's mechanisms of action on articular tissues (cartilage, synovial membrane and subchondral bone) and justified its ef...

Have a Nice Conflict

AORN Journal — Mon, 30 Jan 2012 03:56:37 +0100

This book demonstrates that conflict is inevitable in life, but we can learn to manage conflict in a constructive and advantageous manner while experiencing better results and outcomes. The authors tell the story of a salesman overlooked for yet another promotion and how he strives to improve both his professional and personal relationships by learning to resolve conflict in a productive way. They discuss how to work with other people, make coworkers feel worthwhile, and strengthen and build relationships whenever possible. The book is written in a conversational style that makes it both entertaining and easy to read. (Source: AORN Journal)

Friendship: The Whole Truth, Nothing but the Truth --- What Do You Think?

Psychology Today Relationships Center — Sat, 28 Jan 2012 16:37:58 +0100

After recently spending some time away with a close friend, I realize I don't like many aspects of her personality... I would never want to tell someone I do not want to be friends because I don't think that they are a very nice person... read more (Source: Psychology Today Relationships Center)

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10 Tools to Get Closer with the One You Love

Psychology Today Sex Center — Fri, 27 Jan 2012 16:49:34 +0100

Emotional support comes in a variety of shapes and sizes. Having the desire and ability to be giving to your partner is far more important than doing it exactly right. Here are some tips to help you nourish each other's hearts.read more (Source: Psychology Today Sex Center)

NICE issues draft guidelines for early-onset neonatal infections . . .

PharmacoEconomics and Outcomes News — Fri, 27 Jan 2012 15:13:30 +0100

(Source: PharmacoEconomics and Outcomes News)

One in four NHS trusts exclude NICE-approved drugs

PharmacoEconomics and Outcomes News — Fri, 27 Jan 2012 15:13:30 +0100

(Source: PharmacoEconomics and Outcomes News)

NICE's STA process assessed

PharmacoEconomics and Outcomes News — Fri, 27 Jan 2012 15:13:30 +0100

(Source: PharmacoEconomics and Outcomes News)

NICE wants more info on rivaroxaban for AF . . .

PharmacoEconomics and Outcomes News — Fri, 27 Jan 2012 15:13:30 +0100

(Source: PharmacoEconomics and Outcomes News)

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"HER Majesty's a Pretty Nice Girl but She Changes From Day to Day" [CORRESPONDENCE]

Journal of Clinical Oncology — Fri, 27 Jan 2012 05:00:00 +0100

(Source: Journal of Clinical Oncology)

Diagnosis and management of the epilepsies in adults and children: summary of updated NICE guidance

NeLM - News — Fri, 27 Jan 2012 05:00:00 +0100

This article summarises the main recommendations of the updated NICE guideline covering the diagnosis and management of epilepsies in adults and children. (Source: NeLM - News)

NICE approves new generation CT scanners

NHS Networks — Fri, 27 Jan 2012 05:00:00 +0100

CT scanners are used to evaluate the function of the heart, its arteries and the degree of calcium build up. However, in certain people imaging can be difficult with older types of CT scanners. This can be due to obesity, and higher levels of calcium in the heart. NICE has approved the use of the new generation CT scanners because they have a number of advantages over the older type CT scanners for people with CAD in whom imaging is difficult, allowing them to produce better images and in a shorter period of time, within one or two heartbeats. (Source: NHS Networks)

NICE guidance advises caution on asthma heat treatment

Nursing Times Breaking News — Thu, 26 Jan 2012 09:54:00 +0100

Clinicians should take special care when deciding whether to use new non-drug treatment for severe asthma because more research is needed into the practice, latest guidance state. (Source: Nursing Times Breaking News)

Is there any scientific evidence for the use of glucosamine in the management of human osteoarthritis?

Arthritis Research and Therapy — Thu, 26 Jan 2012 05:00:00 +0100

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New advice on anti-epileptic drugs

NHS Networks — Thu, 26 Jan 2012 05:00:00 +0100

Epilepsy affects up to an estimated 415,000 people in England, and two-thirds of people with active epilepsy have their condition satisfactorily controlled by AEDs. NICE first published guidance on epilepsy in 2004 that included recommendations on the use of AEDs, as well as advice on the diagnosis, treatment and further management of the condition. As recent years have seen a rise in the number of AEDs being prescribed, NICE has now updated this clinical guideline to provide information on newer AEDs. The update describes how and when newer AEDs should be considered alongside older medicines, and can help GPs ensure they are prescribing treatments that are effective both clinically and cost effective. (Source: NHS Networks)

NICE issues guidelines on diagnosis and management of the epilepsies in adults and children in primary and secondary care

NeLM - Guidelines — Thu, 26 Jan 2012 05:00:00 +0100

Source: NICE Area: Evidence > Guidelines This clinical guideline offers evidence-based advice on the care and treatment of children, young people and adults with epilepsy. It updates and replaces NICE clinical guideline 20, published in 2004 and NICE technology appraisal 76 (2004) and 79 (2004). New recommendations have been added for the pharmacological treatment of people with epilepsy, including the use of ketogenic diet. (Source: NeLM - Guidelines)

Patient Portals an EHR Necessity

ICMCC: The International Council on Medical and Care Compunetics — Wed, 25 Jan 2012 16:32:34 +0100

Source: Ron Sterling, HITECHAnswers Content: “Patient portals facilitate the exchange of information between patients and physician practices. What was once considered a nice option for your EHR is becoming a necessity. Unfortunately, not all patient portals offer the same features. Failure to acquire an adequate patient portal could limit your EHR benefits and increase your [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

NICE issues final guidance on apixaban for the prevention of VTE after total hip or knee replacement in adults

NeLM - Guidelines — Wed, 25 Jan 2012 05:00:00 +0100

Source: NICE Area: Evidence > Guidelines NICE has issued final guidance recommending the use of apixaban for the prevention of venous thromboembolism (VTE) after total hip or knee replacement in adults (TA 245). (Source: NeLM - Guidelines)

NICE issues final guidance on rituximab for follicular lymphoma

NeLM - Guidelines — Wed, 25 Jan 2012 05:00:00 +0100

Source: NICE Area: Evidence > Guidelines NICE has issued final guidance on the use rituximab for the treatment of symptomatic stage III and IV follicular lymphoma in previously untreated people (TA 243). The guidance recommends rituximab in combination with the following as a treatment option: . cyclophosphamide, vincristine and prednisolone (CVP) . cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) mitoxantrone, chlorambucil and prednisolone (MCP) . cyclophosphamide, doxorubicin, etoposide, prednisolone and interferon-? (CHVPi) . chlorambucil (Source: NeLM - Guidelines)

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NICE issues final guidance on cetuximab, bevacizumab and panitumumab for metastatic colorectal cancer (second-line)

NeLM - Guidelines — Wed, 25 Jan 2012 05:00:00 +0100

Source: NICE Area: Evidence > Guidelines NICE has issued final guidance on the use of cetuximab, bevacizumab and panitumumab for the second-line treatment of metastatic colorectal cancer (TA 242) which contains the following recommendations: . Cetuximab monotherapy or combination chemotherapy is not recommended for the treatment of people with metastatic colorectal cancer that has progressed after first-line chemotherapy. . Bevacizumab in combination with non-oxaliplatin (fluoropyrimidine-based) chemotherapy is not recommended for the treatment of people with metastatic colorectal cancer that has progressed after first-line chemotherapy. . Panitumumab monotherapy is not recommended for the treatment of people with metastatic colorectal c...

NICE issues final guidance on roflumilast for severe COPD

NeLM - Guidelines — Wed, 25 Jan 2012 05:00:00 +0100

Source: NICE Area: Evidence > Guidelines NICE has issued final guidance (TA 244) on roflumilast for the management of severe chronic obstructive pulmonary disease (COPD), which contains the following recommendations: . Roflumilast is recommended only in the context of research as part of a clinical trial for adults with severe COPD (defined as forced expiratory volume in 1 second [FEV1] post-bronchodilator less than 50% predicted) associated with chronic bronchitis with a history of frequent exacerbations as an add-on to bronchodilator treatment. . Such research should be designed to generate robust evidence about the benefits of roflumilast as an add-on to long-acting muscarinic antagonists (LAMA) plus long-acting beta2 agonists (LABA) plus inhaled cor...

Arkansas Unemployment Drops to 7.7 Percent; Pakko: 'Nice Way to End Year'

Arkansas Business - Health Care — Tue, 24 Jan 2012 15:41:52 +0100

UALR economist Michael Pakko said the December employment data represented a good start to 2012, but warned that the numbers weren't all good. (Source: Arkansas Business - Health Care)

Access to the next wave of biologic therapies (Abatacept and Tocilizumab) for the treatment of rheumatoid arthritis in England and Wales

Clinical Rheumatology — Tue, 24 Jan 2012 07:54:07 +0100

Abstract Patients in England and Wales with rheumatoid arthritis (RA) receive treatment from the National Health Service (NHS) with therapies approved by the European Medicines Agency (EMA), under guidance from the National Institute for Health and Clinical Excellence (NICE). This document overviews the current NICE guidelines for the treatment of RA and identifies scenarios when such guidance may not represent the optimum management strategy for individual patients. Specifically, we consider the use of tocilizumab or abatacept as the most appropriate treatments for some patients. In such scenarios, it may be possible for the clinician to secure access to the required therapy through an application procedure known as an ‘individual funding request’, the process of whic...

Work of breathing to optimize noninvasive ventilation in bronchiolitis obliterans

Intensive Care Medicine — Tue, 24 Jan 2012 06:42:31 +0100

Content Type Journal ArticleCategory CorrespondencePages 1-3DOI 10.1007/s00134-012-2469-4Authors Lisa Giovannini-Chami, Pediatric Pulmonary Department, Hôpitaux Pédiatriques de Nice CHU-Lenval, 06200 Nice, FranceSonia Khirani, Pediatric Pulmonary Unit, National Reference Center for Rare Lung Diseases, INSERM UMR S-938, AP-HP, Hôpital Armand-Trousseau, Université Pierre et Marie Curie-Paris 6, 28 avenue du Docteur Arnold Netter, 75012 Paris, FranceGuillaume Thouvenin, Pediatric Pulmonary Unit, National Reference Center for Rare Lung Diseases, INSERM UMR S-938, AP-HP, Hôpital Armand-Trousseau, Université Pierre et Marie Curie-Paris 6, 28 avenue du Docteur Arnold Netter, 75012 Paris, FranceAdriana Ramirez, Pediatric Pulmonary Unit, National Reference Center for Rare Lung Diseases, I...

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The payout to the boss of RBS is a disastrous deal for the taxpayer | Aditya Chakrabortty

Guardian Unlimited Science — Mon, 23 Jan 2012 20:00:00 +0100

Ministers could act over Stephen Hester, the most lavishly rewarded public servant of all – but will they?How much would you pay the boss of RBS? No one in Westminster would be crass enough to put it like that, naturally; but that's the fundamental question party leaders are addressing in their arguments about Stephen Hester's bonus.Except that when Ed argues that the chief executive shouldn't get his annual top-up, and Nick coughs about the need for restraint and Dave tries to get everyone to look away by loosing the hounds on Fred Goodwin, they always leave out the most important bit: how Hester's payout is taxpayer money. As chief executive of a bank that is 83% owned by taxpayers, Hester is as much a public-sector worker as anyone behind the desk at your local JobCentre. If ministers...

Scrapped NICE guides 'may hit workload'

HealthcareRepublic Pharmacist News — Mon, 23 Jan 2012 00:00:00 +0100

NICE's decision to scrap 'quick reference guides' that summarise its guidance has sparked concern among GPs who fear it will increase workload and lead to fewer clinicians reading new advice. (Source: HealthcareRepublic Pharmacist News)

Dabigatran Etexilate for the Prevention of Venous Thromboembolism in Patients Undergoing Elective Hip or Knee Surgery: A NICE Single Technology Appraisal

PharmacoEconomics — Sat, 21 Jan 2012 14:53:51 +0100

(Source: PharmacoEconomics)

Don't Try to Reason with Unreasonable People

Psychology Today Personality Center — Fri, 20 Jan 2012 18:11:13 +0100

Tired of being belittled, misunderstood, or having your words twisted around by a bully? If you're a "normal" nice person, when you encounter someone difficult your natural reaction is to try to reason with them and win them over. Forget it! Medical doctor and life coach Dr. Susan Biali explains simple strategies for dealing with these types once and for all.read more (Source: Psychology Today Personality Center)

NICE guidance on CardioQ™ oesophageal Doppler monitoring

Anaesthesia — Fri, 20 Jan 2012 12:17:42 +0100

(Source: Anaesthesia)

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Capturing all of the costs in NICE appraisals: the impact of inflammatory rheumatic diseases on productivity

Rheumatology — Fri, 20 Jan 2012 05:00:00 +0100

Inflammatory rheumatic diseases are common. It is estimated that ~2.1% of the population has an inflammatory rheumatic disease (Andrianakos A, Trontzas P, Christoyannis F et al. Prevalence of rheumatic diseases in Greece: a cross-sectional population based epidemiological study. The ESORDIG Study. J Rheumatol 2003;30:1589–601). For diseases such as RA, PsA and AS, onset is most frequent between the ages of 30 and 50 years. The impact of inflammatory rheumatic diseases on physical functioning can be significant. Patients can suffer from swollen joints that cause pain and disability. This can reduce sufferers’ ability to lead fully productive lives. This has major financial consequences for sufferers and their families and there is an economic impact on society. The National Inst...

Nurses follow NICE blood clot guidelines

NHS Networks — Fri, 20 Jan 2012 05:00:00 +0100

It is estimated that 25,000 people who are admitted to hospital die from preventable VTE every year, leading the Department of Health to make prevention a priority across the NHS for the forthcoming years.In order to improve adherence to the NICE VTE guideline, the Royal College of Nursing (RCN) developed a free and interactive e-learning module, focusing on the practical aspects of blood clot prevention. More ….. (Source: NHS Networks)

Carotid artery stenting: the 2011 NICE guidelines

Heart — Fri, 20 Jan 2012 05:00:00 +0100

Death and disability as a result of cerebrovascular disease are a significant and growing problem in our ageing society. Surgery for significant carotid artery stenosis (>50%) in the form of carotid endarterectomy (CEA) reduces the subsequent risk of ipsilateral stroke. This benefit is particularly evident in recently symptomatic patients with minor stroke or transient ischaemic attack.1 2 Asymptomatic subjects with significant carotid artery stenosis (>70%) also benefit from surgery (stroke risk at 10 years 10.8% vs 16.9% with medical treatment (gain of 6.1%, 95% CI 2.7% to 9.4%)).3 Carotid artery stenting (CAS) is a less invasive alternative to CEA avoiding the morbidity associated with a surgical incision. However, CAS is a technically demanding procedure and some early resul...

US Incomes Are Rising But It's All Going on Health Care

Forbes.com Healthcare News — Thu, 19 Jan 2012 18:01:20 +0100

A very nice observation here from Tim Taylor. We're all aware of the figures that show that US incomes aren't rising, that median income has been static and so on. However, this isn't quite the right way to measure it, just wage income. We really ought to use labour compensation and that has been rising. (Source: Forbes.com Healthcare News)

Are medical communities the new marketing demographic?

Thrive, Children's Hospital Boston — Thu, 19 Jan 2012 13:48:19 +0100

Have you heard about the bald Barbie movement? It’s a grassroots, digital campaign asking Mattel to make a version of the doll without her trademark golden locks to benefit children with illness. According to the group’s Facebook page, which has gained more than 130,000 fans in less than a month, bald Barbie would let “children suffering cancer, alopecia and any other illness that causes them to lose their hair, feel just as beautiful as the dolls they play with.” Regardless of how people feel about the plastic fashion icon—she’s been around for more than half a century but still seems to be a very polarizing figure; often because of her figure—the online support for bald Barbie is undeniable. Many people seem ready to overlook any issues they may have had...

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Discussion

The Journal of Thoracic and Cardiovascular Surgery — Thu, 19 Jan 2012 09:10:17 +0100

Dr Michael Mulligan (Seattle, Wash). Congratulations on your paper and a very nice presentation. I always appreciate seeing a lot of effort put into work, and clearly you did that. I noticed the article that your group put out via e-publication last month evaluating ICAM regulation with sPLA2 in esophageal cancer cells, and this is a nice extension of that work. It is always difficult to know what the next great research question is and you seem to be onto something here. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Use of hydroxychloroquine in corticodependent and recurrent scleritis

Graefe's Archive for Clinical and Experimental Ophthalmology — Thu, 19 Jan 2012 06:57:37 +0100

Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00417-011-1922-3Authors Célia Maschi, Service Ophtalmologie, Hopital Saint Roch, CHU-Nice, 5, rue Pierre Dévoluy, Nice, 06000 FranceNathalie Tieulié, Service de Médecine interne, Hopital Archet 1, CHU-Nice, Nice, FrancePierre Gastaud, Service Ophtalmologie, Hopital Saint Roch, CHU-Nice, 5, rue Pierre Dévoluy, Nice, 06000 FranceStéphanie Baillif, Service Ophtalmologie, Hopital Saint Roch, CHU-Nice, 5, rue Pierre Dévoluy, Nice, 06000 France Journal Graefe's Archive for Clinical and Experimental OphthalmologyOnline ISSN 1435-702XPrint ISSN 0721-832X (Source: Graefe's Archive for Clinical and Experimental Ophthalmology)

Advice to Paula Deen From Someone with 20 Years of Diabetes Under Their Belt

About Diabetes — Wed, 18 Jan 2012 05:00:00 +0100

Paula Deen, the famous 64-year-old television queen of decadent southern cooking, revealed on the Today Show yesterday that she has type 2 diabetes after years of rumor and speculation. She has had diabetes for three years and made the announcement the same day her diabetes website was announced. This is a website sponsored by a pharmaceutical company (Novo Nordisk) that is paying her to be a spokesperson to peddle a diabetes drug (Victoza). Oh yes, and her sons are also being reimbursed for their endorsements and one son has started a new cooking show on the Cooking Network featuring lighter versions of his mom's recipes. Today Deen is facing a backlash. She has now announced she is in a position where a percentage of the endorsement money can go to the American D...

Controversies and advances in non-steroidal anti-inflammatory drug (NSAID) analgesia in chronic pain management

Postgraduate Medical Journal — Wed, 18 Jan 2012 05:00:00 +0100

Chronic pain can lead to significant disability with social and economic implications in the community. Traditional non-steroidal anti-inflammatory drugs (NSAIDs) have been part of the management of chronic pain. The risk of adverse events with traditional NSAIDs has led to the development of alternative therapeutic options. Differential blockade of the enzymes involved in pain and inflammation can offer therapeutic options without the gastrointestinal side effects. However, this may be at the expense of other major cardiovascular side effects. Pain pathways that involve peripheral transmission may be altered by local application of analgesia to the skin overlying the painful area. Recent guidelines for osteoarthritis treatment from the National Institute for Health and Clinical Excellence...

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The Memory Palace: A Memoir

Psych Central — Tue, 17 Jan 2012 20:18:26 +0100

We children of schizophrenics are the great secret-keepers, the ones who don’t want you to think anything is wrong (p. 5). Author Mira Bartok has encapsulated in this statement her life as the daughter of mentally ill musical prodigy Norma Herr. The Memory Palace describes Ms. Bartok’s journey from scared child to haunted college student to free adult and finally back again to scared child, sitting at her mother’s bedside as she succumbs to the effects of a lifetime of poor (mostly homeless) living. It is a moving, evocative story, relating Norma’s schizophrenic mind to Mira’s later experience with traumatic brain injury, and how this helped them to reconcile after 30 years of estrangement. A difficult read at times due to the subject matter, The Memory Palace is nonetheles...

Winter walk [video] | GrrlScientist

Guardian Unlimited Science — Tue, 17 Jan 2012 08:00:00 +0100

A winter walk through the hills near the Natural History Museum in TringIf you're like me, you're probably wondering what happened to winter this year. In my neck of the woods, we had a light dusting of snow that lasted for roughly three hours this winter season, and it doesn't look as though any more is on the way. So if you're missing snow, here's a nice little video, courtesy of the Natural History Museum in Tring, of a winter walk around the snowy hills of Tring with museum botanist Fred Rumsey: Visit NaturalHistoryMuseum's YouTube channel [video link]. What animal was chewing on the cherry stones? .. .. .. .. .. .. .. .. .. .. .. .. The Natural History Museum at Tring is on facebook and on twitter @NHM_Visiting .. .. .. .. .. .. .. .. .. .. .. .. twitter: @GrrlScientist facebook: grrl...

Bacterial meningitis and meningococcal septicaemia

NHS Networks — Tue, 17 Jan 2012 05:00:00 +0100

An update from NHS Evidence providing a summary of selected new evidence relevant to NICE clinical guideline 102: ”Management of bacterial meningitis and meningococcal septicaemia in children and young people younger than 16 years in primary and secondary care (2010).” (Source: NHS Networks)

External Aortic Root Support: NICE GuidanceExternal Aortic Root Support: NICE Guidance

Medscape Today Headlines — Tue, 17 Jan 2012 04:00:00 +0100

Where does external aortic root support, and the guidance concerning it, fit into present practice? Heart (Source: Medscape Today Headlines)

How about a nice cup of tea?

Daily Express - Health — Tue, 17 Jan 2012 00:00:00 +0100

TEA is our national drink and we get through 165 million cuppas every day: more than is consumed throughout India. Most of us regularly enjoy some variety of tea and we each consume about 1,000 cups a year. (Source: Daily Express - Health)

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Get Off on the Right Foot So Your Viewpoints Won't Get Left Out

Psychology Today Personality Center — Mon, 16 Jan 2012 23:52:00 +0100

Here's six safe sentence-starters, for use at home or at work. The first four starters launch explanations of your perspective. The last two are for responding to your dialogue partner's comments. Put all six together to co-create mutual understanding and win-win solutions. read more (Source: Psychology Today Personality Center)

British Medical Journal features discussion of hypertension guidelines

NeLM - News — Mon, 16 Jan 2012 05:00:00 +0100

Source: British Medical Journal Area: News The British Medical Journal has featured 3 "Analysis" articles in which the authors discuss the 2011 NICE clinical guidelines on the management of hypertension. One article, written by members of the NICE hypertension guideline development group supports the guideline by describing the evidence and considerations that had been used to draw up the guideline. The other 2 articles argue that the guidelines need updating both in light of evidence to suggest that all classes of blood pressure lowering drugs are broadly equivalent, and certain assumptions in the guideline that are based on insufficient evidence. The authors of one of the articles that suggest that the guideline needs updating, state that the following statements in the clini...

Guide for commissioners on end of life care for adults

NHS Networks — Mon, 16 Jan 2012 05:00:00 +0100

The guide aims to support local implementation of the Department of Health (2008) End of Life Care Strategy and the NICE (2011) Quality Standard for end of life care for adults, and is aligned with the NHS Outcomes Framework and supports commissioning for Quality, Innovation, Productivity and Prevention (QIPP).The guide includes an end of life care commissioning and benchmarking tool to help users determine the level of service that might be needed locally and to help cost and identify potential savings associated with commissioning end of life care services. (Source: NHS Networks)

RE: Letter to the Editor regarding 'The effect of applying NICE guidelines for the investigation of stable chest pain on out-patient cardiac services in the UK'

QJM — Mon, 16 Jan 2012 05:00:00 +0100

(Source: QJM)

New NICE guidelines for suspected anaphylactic episodes

PharmacoEconomics and Outcomes News — Sun, 15 Jan 2012 04:11:42 +0100

(Source: PharmacoEconomics and Outcomes News)

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NICE recommends four drugs

PharmacoEconomics and Outcomes News — Sun, 15 Jan 2012 04:11:42 +0100

(Source: PharmacoEconomics and Outcomes News)

The importance of observing

Guardian Unlimited Science — Sun, 15 Jan 2012 00:28:00 +0100

To commit something to memory, you need to pay attention the next time you encounter something – or someone – new• Click here to download your daily memory taskNever was the phrase "a job well begun, is a job half done" truer than in the case of memory. All memories begin with what you perceive – with how you see, hear and feel the world. And for that simple reason, the first way to boost your memory is to make sure that you experience the world as vividly, clearly and meaningfully as possible.To understand how to do this, we need to appreciate that our senses are not designed to record the world, but instead to make sense of it. Where cameras take instantaneous, detailed snapshots of our surroundings, human perception takes time and is full of creativity and imagination. To experi...

How I remember: The lifelogger

Guardian Unlimited Science — Sat, 14 Jan 2012 00:22:01 +0100

Gordon Bell records much of his life on a specially developed camera, which can be used to remember where you left your keysI got my SenseCam in 2003. It is a camera developed by Lyndsay Williams at Microsoft's Cambridge lab, which you dangle around your neck like a pendant. It's black, about the size of a cigarette packet, and it's got a fisheye lens that has maybe a 135-degree field of view. The device automatically takes a picture roughly every 20 seconds, providing it is still, which is 180 photos an hour.The new one also has a button on it that turns the camera off for two minutes. This turns out to be fairly handy feature, because otherwise you end up with a lot of pictures of toilets. It doesn't record audio; that was felt to be too intrusive.It was designed to be worn 24/7, lo...

Do Nice Guys Finish Last…Financially?

Psychology Today Personality Center — Fri, 13 Jan 2012 21:07:29 +0100

Easygoing guys and empty bank accounts. Being agreeable just doesn't pay.read more (Source: Psychology Today Personality Center)

NICE recommends once-weekly diabetes drug

Nursing in Practice — Fri, 13 Jan 2012 15:41:29 +0100

The NHS drugs watchdog has recommended a once-weekly injection for patients with type 2 diabetes read more (Source: Nursing in Practice)

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NICE issues costing statement for its guidance on dasatinib, high-dose imatinib and nilotinib for chronic myeloid leukaemia (CML)

NeLM - News — Fri, 13 Jan 2012 05:00:00 +0100

Source: NICE Area: News NICE has published guidance (Technology Appraisal 241) on the use of dasatinib, high-dose imatinib and nilotinib for the treatment of imatinib-resistant chronic myeloid leukaemia (CML) (part review of NICE technology appraisal guidance 70), and dasatinib and nilotinib for people with CML for whom treatment with imatinib has failed because of intolerance. The costing statement notes that standard-dose imatinib is the current standard of care for first-line treatment of CML (as recommended in TA 70). Although the use of high-dose imatinib following resistance is recommended only in the context of research, specialists suggest that this, in addition to dasatinib and nilotinib, are used widely in the UK. This guidance recommends nilotinib fo...

NICE issues final appraisal determination on prolonged-release exenatide for type 2 diabetes

NeLM - News — Fri, 13 Jan 2012 05:00:00 +0100

Source: NICE Area: News NICE has published a Final Appraisal Determination (FAD) on the use of prolonged-release exenatide in combination with oral antidiabetic therapy for the treatment of type 2 diabetes. The recommendations made are as follows: 1.1 Prolonged-release exenatide in triple therapy regimens (in combination with metformin and a sulphonylurea, or metformin and a thiazolidinedione) is recommended as a treatment option for people with type 2 diabetes as described in NICE clinical guideline 87; that is, when control of blood glucose remains or becomes inadequate (HbA1c ? 7.5% [59 mmol/mol] or other higher level agreed with the individual), and the person has: . a body mass index (BMI) ? 35 kg/m2 in those of European family origin (with appropriat...

NICE opens up access to The Lancet

NHS Networks — Fri, 13 Jan 2012 05:00:00 +0100

The move will save the NHS time and money as NHS organisations, and individual members of staff, will no longer need to take out their own subscriptions to the online and paper versions of The Lancet. Founded in 1823, The Lancet is one of the oldest and most respected medical journals in the world. This three-year agreement will provide all NHS staff who have an Athens password access to the latest copies of The Lancet, as well as back copies from the last four years, through NHS Evidence - the online service provided by NICE. (Source: NHS Networks)

NHS staff given free access to The Lancet

OnMedica Latest News — Fri, 13 Jan 2012 05:00:00 +0100

NICE funds open online access to The Lancet for all working in NHS EnglandRelated items from OnMedicaIraqi doctors given online access to medical educationCareer break need not scupper revalidationMedical journal 2.0New journal asks doctors to share experiences onlineShelve the sweet talking drug reps, say doctors (Source: OnMedica Latest News)

NICE issues final guidance on dasatinib, high-dose imatinib and nilotinib for chronic myeloid leukaemia (CML)

NeLM - Guidelines — Fri, 13 Jan 2012 05:00:00 +0100

Source: NICE Area: Evidence > Guidelines NICE has published a technology appraisal (TA 241) on the use of dasatinib, high-dose imatinib and nilotinib for the treatment of imatinib-resistant chronic myeloid leukaemia (CML) (part review of NICE technology appraisal guidance 70), and dasatinib and nilotinib for people with CML for whom treatment with imatinib has failed because of intolerance. The main recommendations regarding the use of these medicines within the NHS in England and Wales are as follows: . Nilotinib is recommended for the treatment of chronic or accelerated phase Philadelphia-chromosome-positive CML in adults whose CML is resistant to treatment with standard-dose imatinib or who have imatinib intolerance, as long as the manufacturer m...

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Search for a gene responsible for Floating‐Harbor syndrome on chromosome 12q15q21.1

American Journal of Medical Genetics Part A — Fri, 13 Jan 2012 05:00:00 +0100

AbstractFloating‐Harbor syndrome (FHS) is characterized by characteristic facial dysmorphism, short stature with delayed bone age, and expressive language delay. To date, the gene(s) responsible for FHS is (are) unknown and the diagnosis is only made on the basis of the clinical phenotype. The majority of cases appeared to be sporadic but rare cases following autosomal dominant inheritance have been reported. We identified a 4.7 Mb de novo 12q15‐q21.1 microdeletion in a patient with FHS and intellectual deficiency. Pangenomic 244K array‐CGH performed in a series of 12 patients with FHS failed to identify overlapping deletions. We hypothesized that FHS is caused by haploinsufficiency of one of the 19 genes or predictions located in the deletion found in our index patient. Since none...

Responsibly Managing Uncertainties In Clinical Ethics.

The Journal of Medicine and Philosophy — Fri, 13 Jan 2012 05:00:00 +0100

Authors: McCullough LB Abstract It is well-recognized that uncertainty is an endemic feature and limitation of clinical judgment and practice that cannot be eliminated in many cases. Among the tasks of clinical ethics is the responsible management of uncertainties, first articulated in E. Haavi Morreim's very nice concept of the "moral management of medical uncertainty." The papers in the 2012 Clinical Ethics issue of the Journal provide philosophically innovative and clinically applicable accounts of the varieties of uncertainty in clinical medicine and therefore in clinical ethics: epistemic uncertainty, metaphysical uncertainty, and relational uncertainty. PMID: 22246973 [PubMed - as supplied by publisher] (Source: The Journal of Medicine and Philosophy)

NICE FAD does not recommend cabazitaxel for the second line treatment of prostate cancer

NeLM - News — Thu, 12 Jan 2012 05:00:00 +0100

Source: NICE Area: News NICE has issued a Final Appraisal Determination (FAD) on the use of cabazitaxel for the second line treatment of hormone refractory, metastatic prostate cancer. The FAD does not recommend cabazitaxel in combination with prednisone or prednisolone for the treatment of hormone-refractory metastatic prostate cancer previously treated with a docetaxel-containing regimen. In a related press release, the Chief Executive of NICE said, "We need to be sure that new treatments provide sufficient benefits to patients to justify the significant resources the NHS would need to make available. Although cabazitaxel has been shown to be effective in extending life, it is also associated with a number of side effects. The committee was concerned about the natu...

NICE publishes costing template for guidance on ticagrelor in acute coronary syndromes

NeLM - News — Thu, 12 Jan 2012 05:00:00 +0100

Source: NICE Area: News NICE has published a costing template to accompany its guidance issued in October 2011 on the use of ticagrelor in acute coronary syndromes (ACS). The costing template can be used by health communities to assess the local impact of implementing the guidance, based on the local population. The template does not provide estimates of future practice and therefore an overall cost impact figure is not available. Organisations should insert local assumptions in the template to reflect local circumstances to obtain the impact of implementing this guidance for them locally. (Source: NeLM - News)

NICE issues clinical guideline on the diagnosis and management of the epilepsy in adults and children in primary and secondary care

NeLM - Guidelines — Thu, 12 Jan 2012 05:00:00 +0100

Source: NICE Area: Evidence > Guidelines NICE has published a clinical guideline (CG137) offering evidence-based advice on the care and treatment of children, young people and adults with epilepsy. New recommendations have been added for the pharmacological treatment of people with epilepsy, including the use of a ketogenic diet. This clinical guideline updates and replaces NICE clinical guideline 20, published in 2004. It also updates and replaces NICE technology appraisal 76 (2004) and NICE technology appraisal 79 (2004 (Source: NeLM - Guidelines)

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PCTs will be forced to make NICE-approved drugs available

HealthcareRepublic Pharmacist News — Wed, 11 Jan 2012 10:20:00 +0100

through the introduction of an 'effective compliance regime', according to health secretary Andrew Lansley. (Source: HealthcareRepublic Pharmacist News)

Question 2 Does regular cleaning of stethoscopes result in a reduction in nosocomial infections?

Archives of Disease in Childhood — Wed, 11 Jan 2012 05:00:00 +0100

Scenario The hospital infection control policy suggests that the stethoscope diaphragm should be cleaned before and after each patient contact. You wonder whether regular cleaning of stethoscopes results in a reduction in hospital acquired infections. Structured clinical question In hospital patients [population], does regular cleaning of stethoscopes [intervention] reduce the incidence of nosocomial infection [outcome]? Search strategy and outcome The following resources were searched: Cochrane Library, Trip Database, Medline, PubMed, NHS Evidence and NICE. PubMed search words used were "stethoscope" AND "nosocomial", "hospital acquired", "HAI" AND "infection", "pathogen". No limits were placed on the search. Fourteen of the papers found were relevant and after further review, four were c...

Pick Your Poison

The Poison Review — Wed, 11 Jan 2012 02:35:27 +0100

3 out of 5 stars The Not-so-Nice spice: A Teenage Girl With Palpitations and Dry Mouth. Shah AM et al. Pediatr Emerg Care 2011 Dec;27:1205-7. PubMed Listing This short case report is presented in the form of a diagnostic puzzler. A pregnant 17-year-old woman presents to the emergency department with palpitations, dry mouth, nausea, dizziness, tachycardia (131/min). She reports that several hours before presentation she had ingested a powder from the spice rack at home in an attempt to get high. [Click on the following questions to reveal the answer] What did this patient ingest? expand(document.getElementById('ddet2057913483'));expand(document.getElementById('ddetlink2057913483')) Nutmeg powder. This spice has a reputation as a hallucinogen, but the symptoms associated with ingestion o...

Nice- approved drugs must be made available, pledges Andrew Lansley

Telegraph Health — Tue, 10 Jan 2012 18:28:09 +0100

Health authorities will be forced to provide patients with drugs officially approved for prescription on the NHS, Andrew Lansley, the Health Secretary, has told MPs. (Source: Telegraph Health)

UK's NICE Wants More Data on Rivaroxaban in AFUK's NICE Wants More Data on Rivaroxaban in AF

Medscape Today Headlines — Mon, 09 Jan 2012 19:18:03 +0100

The UK drugs cost-efficacy watchdog, NICE, has asked for more data from Bayer before it will sanction use of rivaroxaban for stroke prevention in atrial fibrillation patients. Heartwire (Source: Medscape Today Headlines)

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UK's NICE wants more data on rivaroxaban in AF

theHeart.org — Mon, 09 Jan 2012 15:50:00 +0100

The UK drugs cost-efficacy watchdog, NICE, has asked for more data from Bayer before it will sanction use of rivaroxaban for stroke prevention in atrial-fibrillation patients. (Source: theHeart.org)

NICE opens 2013/14 QOF consultation

Management in Practice — Mon, 09 Jan 2012 13:06:00 +0100

New targets for rheumatoid arthritis, cholesterol and cancer could make 2013-14 QOF plan (Source: Management in Practice)

NICE Needs More Evidence on New Treatment for People with Common Heart Condition

Drugs.com - Pharma News — Mon, 09 Jan 2012 12:01:48 +0100

In preliminary recommendations published today (9 January) NICE is asking Bayer HealthCare for more information on its product rivaroxaban (Xarelto), for the prevention of stroke and systemic embolism in people with atrial fibrillation. Atrial... (Source: Drugs.com - Pharma News)

Chairman of medicines body looks to expand remit

FT.com - Drugs and Healthcare — Sun, 08 Jan 2012 19:17:29 +0100

Previous decisions have drawn the ire of the pharmaceutical industry, which responded in earlier times by lining up with patient groups and the tabloid press, to launch legal challenges against Nice's rulings (Source: FT.com - Drugs and Healthcare)

Health resort opatija volunteer fire brigade and rescue society. - Fischinger J, Fischinger A, Fischinger D.

SafetyLit: All (Unduplicated) — Fri, 06 Jan 2012 15:21:09 +0100

Not only the health service but also several other humanitarian institutions and societies were active in Abbazia÷Opatija, the most important town on the once Austrian Riviera, the town that was also known as the Austrian Nice. The most important of the s... (Source: SafetyLit: All (Unduplicated))

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Professor's cell phone microscope honored as best innovation of 2011

UCLA Newsroom: Health Sciences — Thu, 05 Jan 2012 18:55:00 +0100

A groundbreaking imaging technology developed by UCLA Engineering professor Aydogan Ozcan that can turn a simple cell phone into a powerful microscope has been named the top innovation of 2011 by The Scientist, a magazine focusing on the life sciences, research and technology. Ozcan's compact, lightweight and inexpensive microscope has the potential to bring better health care and monitoring to impoverished and underserved areas of the globe. The technology, known as LUCAS (Ultra–wide-field Cell monitoring Array platform based on Shadow imaging), was ranked No. 1 among a field of more than 65 entries judged by the magazine as part of its annual "Top 10 Innovations" contest. Other winners in the top 10 included a new high-powered DNA sequencer, a mini-MRI system, a watch-like d...

NICE offers New Year guidance

NHS Networks — Thu, 05 Jan 2012 05:00:00 +0100

Around 7m of us will make a New Year's resolution to improve our health, but sticking to it can be tough particularly through the dark winter months ahead. NICE has a suite of public health guidance that can help individuals achieve their resolutions and keep to them, as well as encouraging health professionals, employers and local authorities to do more to support healthy living in 2012. (Source: NHS Networks)

NICE issues for consultation draft guideline on antibiotics for neonatal infection

NeLM - News — Thu, 05 Jan 2012 05:00:00 +0100

Source: NICE Area: News NICE has issued a draft guideline on antibiotics for neonatal infection for consultation from the 3rd January to 27th February 2012. (Source: NeLM - News)

NICE issues infant infection guidance

Nursing Times Breaking News — Wed, 04 Jan 2012 09:57:00 +0100

The NHS is being urged to do more to identify newborn babies at risk of life-threatening infection. (Source: Nursing Times Breaking News)

Possible cues driving context-specific adaptation of optocollic reflex in pigeons (Columba livia)

Journal of Neurophysiology — Wed, 04 Jan 2012 05:00:00 +0100

Context-specific adaptation (Shelhamer M, Clendaniel R. Neurosci Lett 332: 200–204, 2002) explains that reflexive responses can be maintained with different "calibrations" for different situations (contexts). Which context cues are crucial and how they combine to evoke context-specific adaptation is not fully understood. Gaze stabilization in birds is a nice model with which to tackle that question. Previous data showed that when pigeons (Columba livia) were hung in a harness and subjected to a frontal airstream provoking a flying posture ("flying condition"), the working range of the optokinetic head response [optocollic reflex (OCR)] extended toward higher velocities compared with the "resting condition." The present study was aimed at identifying which context cues are instrumenta...

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The Application of High-throughput siRNA Screening Technology to Study Host-Pathogen Interactions.

Combinatorial Chemistry and High Throughput Screening — Wed, 04 Jan 2012 05:00:00 +0100

Authors: Ou L, Duan D, Wu J, Nice E, Huang C Abstract Recent advances in high-throughput screening technologies have accelerated the identification and characterization of potential factors involved in host-virus interactions, facilitating early detection and diagnosis of diseases, as well as providing promising drug targets. The last decade has seen a plethora of successful examples of high-throughput screening approaches, especially siRNA screening. With support from protein interaction studies, mRNA expression profiling, and bioinformatics, siRNA screening has also been successfully utilized to identify host factors required for a number of viruses including HIV, West Nile virus and H1N1 virus. Such studies have raised the awareness of virologists, and have opened a new chapter ...

Colon Cancer Awareness May Save Lives

About.com Colon Cancer — Tue, 03 Jan 2012 05:00:00 +0100

Image © Maksim Shmeljov/Dreamstime Get out your sneakers and clean undies if you live in South Florida - this Saturday heralds the first Undy 5000 of the New Year - a 5K event created by the Colon Cancer Alliance to support colon cancer awareness. Whether you want to walk, run or just enjoy watching the entertainment, it's a nice way to spend a Saturday supporting your favorite cause....Read Full Post (Source: About.com Colon Cancer)

NICE Guideline for Management of Chronic Heart Failure in Adults.

Annals of Internal Medicine — Tue, 03 Jan 2012 05:00:00 +0100

Authors: Simel DL PMID: 22213506 [PubMed - in process] (Source: Annals of Internal Medicine)

NICE approisal of fingolimod (Gilenya)

Multiple Sclerosis Trust — Tue, 03 Jan 2012 00:00:00 +0100

Interview with neurologist Martin Duddy about the NICE appraisal of fingolimod Northern Echo (Source: Multiple Sclerosis Trust)

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What Your Eyebrows May Be Telling You

Al Sears, MD Natural Remedies — Mon, 02 Jan 2012 08:00:05 +0100

I’ve helped thousands of women look and feel more beautiful at my clinic over the years. And I know it’s important to you to keep your eye area looking nice and clean with proper eyebrow grooming. But there’s something important you should know. (Source: Al Sears, MD Natural Remedies)

Are You Bipolar or Just Moody?

Psychology Today Depression Center — Sun, 01 Jan 2012 17:03:43 +0100

It would be nice if there were a simple answer to the question, or even better, if there were a blood test, an MRI or a brain scan to determine bipolar disorder. We're not there yet. What we do have is a set of symptoms which exist on a broad continuum. What gets tricky is identifying where the threshold lies between normal functioning and psychopathology.read more (Source: Psychology Today Depression Center)

50 Years a Biomedical Engineer: Remembering a long and fascinating journey

BioMedical Engineering OnLine — Sun, 01 Jan 2012 05:00:00 +0100

Looking back at one point of life appears as a nice exercise to round out and summarize. However, the objective should not be simply to tell a story; it must transmit a message to the young. To start with, two concepts are useful: " Respect for others begins when you learn to laugh at yourself " and, taken from an old saying, "I did not want to be poor ... but money wouldn't make me rich". After elementary and high schools, during times of turmoil, I describe my engineering school years at the University of Buenos Aires and a working experience in an international telecommunications company. Significant events taught me a concept, rooted in another motto: "Isn't this house nice? It is my house, and I love it very much". In 1960, I began my activities in the USA. A couple of bad decisions r...

[News] Primary care trusts refuse to play NICEly

The Lancet Oncology — Sun, 01 Jan 2012 05:00:00 +0100

In the UK, NICE recommends the drugs that are cost effective for the NHS through evidence-based technology appraisals. However, a report by GP magazine suggested that 33 of 71 primary care trusts (PCTs) have separate lists of drugs that they will not fund for use in primary or secondary care (termed blacklisting), 19 of which are recommended by NICE. That suggestion seems misplaced, at least for cancer drugs. Cambridgeshire PCT was singled out in the report for blacklisting erlotinib, trabectedin, and mifamurtide. (Source: The Lancet Oncology)

[News] NICE approves nilotinib for chronic myeloid leukaemia

The Lancet Oncology — Sun, 01 Jan 2012 05:00:00 +0100

On Dec 6, 2011, in the UK, NICE issued draft new guidance on first-line treatment of chronic myeloid leukaemia (CML). NICE already recommends imatinib, a standard dose of which costs about £20 000. “We are happy to now include nilotinib as a treatment option” a NICE spokesperson told The Lancet Oncology. “Although nilotinib is expensive at over £30 000 per patient per year, the manufacturer offered to provide the drug to the NHS at a discounted price meaning the committee could recommend it.” The size of the discount was not revealed. (Source: The Lancet Oncology)

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Home birth: the case for

Obstetrics, Gynaecology and Reproductive Medicine — Sun, 01 Jan 2012 05:00:00 +0100

Women giving birth in the UK are advised in policy documents that they should expect to have a choice in relation to where they give birth including birth at home. Homebirth is not a new concept. Before 1945 most women in the UK gave birth at home and as recently as 1960 one in three women still did so; now the figure is less than 3%. But why is this? NICE guidance on intrapartum care supports women having a choice of place of birth including homebirth and, whilst acknowledging that the evidence relating to the safety of homebirth is limited, also states that for women choosing birth at home the likelihood of a normal birth is higher and the likelihood of interventions less than for women choosing birth in an obstetric unit. (Source: Obstetrics, Gynaecology and Reproductive Medicine)

Addressing the problems of long-term urethral catheterization: part 2.

British Journal of Nursing — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Wilson M Abstract This is the second of a two-part article and addresses the problems encountered throughout the life of a catheter from those relating to its insertion, through the time when it is in situ, to those associated with its removal. Catheters can cause discomfort and reasons for this are discussed including latex allergy, atrophic changes in women, blockage or bypass. The draft National Institute for Health and Clinical Excellence infection control guidance is discussed with reference to catheter maintenance solutions. Sexuality can be an unvoiced concern to patients with catheters in situ and clinicians are encouraged to discuss such issues with the patient, where relevant. Issues including catheter expulsion, bladder spasm and difficulties in catheter removal...

Management of hyperglycaemia in people with acute coronary syndromes (NICE Clinical Guideline 130): uncertainty persists

Practical Diabetes International — Sun, 01 Jan 2012 05:00:00 +0100

(Source: Practical Diabetes International)

Rewind radio: Today; The Infinite Monkey Cage – review

Guardian Unlimited Science — Sun, 01 Jan 2012 00:04:16 +0100

Guest editor Mo Ibrahim gave Today listeners a compelling picture of African success and western corruptionToday (R4) | iPlayerThe Infinite Monkey Cage (R4) | iPlayerBits and bobs this week: patchy listening in between Christmas carol compilations… Steve Lamacq won the 6 Music v 5 Live quiz, hooray; Woman's Hour offering diets and grandchildren's manners; Huw Stephens on Radio 1 sounding increasingly at home during the day; 5 Live's Stephen Nolan talking to alcoholics who had managed to kick their affliction and those, tragically, who hadn't. (That last made uncomfortable listening: Nolan somehow doesn't seem to get the tone right, as Victoria Derbyshire does. He seems prurient, rather than journalistic.)Anyhow, aside from all that, I have a new hero. His name is Mo Ibrahi...

Meet our Mystery Bird photographers: Dan Logen [Photoessay] | @GrrlScientist

Guardian Unlimited Science — Sat, 31 Dec 2011 16:30:01 +0100

A behind-the-lens glimpse of some of the photographers who share their beautiful work with usI am repeating this opening bit from my original blog entry since some of you may be new to what I hope will be an annual feature on this blog: meet our Mystery Bird photographers. One month ago, I invited "our" Mystery Bird photographers to tell us a little about themselves. In that request, I suggested that if they weren't sure what might interest us, they may wish to respond to any or all of the following questions;-- everyone is passionate about their camera: what specific cameraequipment do you use, and why?-- what is your favourite piece of camera equipment?-- what got you interested in photographing birds?-- where are your favourite places to go birding (and bird photographing), and why?-- w...

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Simple Fruit Platters to Make Life Easier

About Diabetes — Sat, 31 Dec 2011 05:00:00 +0100

Gatherings and parties usually mean there is a nice spread of desserts. I know sometimes I am tempted to pick at them just because they are there. I sit around the table with family and friends and try a bit of this or that, maybe have one more cookie. It's easy to ignore those bits of high carbohydrates that make it into your mouth, and you can unknowingly indulge too much on food that may not even have any good nutrition to offer. Why oh why can't sugar be a high-nutrition food group? What can you do? You can bring a healthier sweet option, one that is brimming in good nutrition that possibly has some health benefits. Here are some very simple ideas for fruit platters. Because we may run into this situation often, it's a good idea to have an ars...

What I Wrote In 2011

Forbes.com Healthcare News — Fri, 30 Dec 2011 17:08:01 +0100

It's been a long and pretty amazing year, both in medicine and here at Forbes. Here's a look at my picks for the ten best stories I wrote this year, along with a list of 20 more that I think are worth mentioning. I did a good job, I think, capturing how the huge industry built around mass market medicines is colliding with a more personalized, genetic approach -- injuring and invigorating both sides. I do wish that I had written a good piece about drug shortages, and had focused more on long-form, in-depth science pieces. But there's always next year for that. Have a look. Hopefully, this is a nice review of how far we've come, and good set up for how far we'll go in 2012. Thank you for reading, thank you for commenting, and feel free to send along ideas and to always keep me honest!...

Neurosurgery at Queen Square

Journal of Pakistan Medical Students — Thu, 29 Dec 2011 05:00:00 +0100

This article has been peer reviewed. Article Submitted on: 9th October 2011 Article Accepted on: 28th November 2011 Funding sources: None declared Correspondence to:Hamza Tariq Medical student Address:King Edward Medical University, Lahore, Pakistan. Email: hamxatariq@yahoo.com Download PDF Elective Report The day I finished studying the anatomy of brain, I knew that I wanted to pursue neurosurgery as a career speciality. A medical student getting fascinated by the mysterious workings of the human brain is not something unusual. Here, in a mere 3 pounds of living tissue, lies the complexity sufficient to incarnate and store the record of a lifetime of the richest human experience. Our brains contain the secrets of ourselves. Its mystery lies in the fact that it con...

Canes for knee osteoarthritis: is a randomised trial necessary?

Annals of the Rheumatic Diseases — Wed, 28 Dec 2011 05:00:00 +0100

In this issue of the Annals, Jones et al1 (pp 172) report the results of a randomised clinical trial (RCT) of canes for knee osteoarthritis. Current recommendations on the management of hip and knee osteoarthritis emphasise non-pharmacological interventions, with sticks or canes universally recommended in existing guidelines.2 According to the Osteoarthritis Research Society International (OARSI) recommendations for the management of hip and knee osteoarthritis one of 25 treatment propositions recommended is ‘Walking aids can reduce pain in patients with hip and knee OA. Patients should be given instruction in the optimal use of a cane or crutch in the contralateral hand. Frames or wheeled walkers are often preferable for those with bilateral disease.’3 In the National Institut...

Questions Kids Ask About ADHD

Psych Central — Wed, 28 Dec 2011 03:15:11 +0100

Attention deficit hyperactivity disorder (ADHD) is a fairly common mental health concern among children and teenagers today. It is readily treated by medications, psychotherapy, or a combination of the two. Here are some commonly asked questions teens have about ADHD, and their answers. Q: What is ADD? A: The letters ADD stand for “attention deficit disorder.” Having attention deficit disorder is like needing to wear glasses. It means you have trouble seeing life clearly. You have trouble paying attention. You may like to move around a lot, and this also makes it hard to pay attention to what is going on. Just as it can be annoying for people who wear glasses to have to put on their glasses, it can be annoying to have ADD. But there is nothing wrong with it. It doesn’t me...

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Fingolimod consultation closes soon

Multiple Sclerosis Trust — Wed, 28 Dec 2011 00:00:00 +0100

Time is running out for replies to the consultation about fingolimod (Gilenya), with comments needing to be with NICE by 5 January. (Source: Multiple Sclerosis Trust)

What do the latest guidelines tell us about UTIs in children under 2 years of age

Pediatric Nephrology — Tue, 27 Dec 2011 16:50:03 +0100

Abstract The American Academy of Pediatrics (AAP) recently published new guidelines on diagnosing and managing infants and children younger than 2 years who have had a febrile urinary tract infection (UTI). They recommend, as previously did the National Institute for Health and Clinical Excellence (NICE) in the UK, a marked reduction in the imaging that these children should undergo. Both NICE and AAP agree that prophylactic antibiotic treatment should not be routinely used in these children, even in those with major vesicoureteric reflux. Content Type Journal ArticleCategory Editorial CommentaryPages 1-3DOI 10.1007/s00467-011-2077-5Authors Kjell Tullus, Pediatric Nephrology, Great Ormond Street Hospital, London, WC1N 3JH UK Journal Pediatric NephrologyOnline I...

Trap door days

Thrive, Children's Hospital Boston — Tue, 27 Dec 2011 13:50:33 +0100

Claire McCarthy MD Christmas Eve is hard for me. It was in the early hours of Christmas Eve sixteen years ago that my newborn son was diagnosed with a horrible brain malformation. My husband and I were wrapping presents late on the 23rd (so now I associate wrapping presents with this diagnosis and throw everything I can into gift bags) when he began to have seizures so bad that we called an ambulance. Over the night the news went from bad to worse, and by dawn we knew that he would be severely disabled and die young. He died less than a year later. It was a very long time ago, but grief has a way of working its way into your bones and nerves. I mourn the loss of my son every Christmas Eve—the loss of the healthy baby I thought I had until then, and the loss of the blessing Aidan turned ...

3. Management of carcinoma with unknown primary: what does a radiologist need to know?

Cancer Imaging — Mon, 26 Dec 2011 17:24:03 +0100

Authors: Aurangabadkar A, Thind R, Marshall E Abstract Widespread metastatic disease with no obvious primary on initial investigations is a diagnostic challenge often encountered by radiologists. Carcinoma of unknown primary origin (CUP) forms a heterogeneous group of cancers constituting approximately 3-5% of new cancers and amongst the top 10 causes of cancer-related deaths worldwide. A radiologist is often the first physician to identify a potential CUP, orchestrating further invasive or non-invasive investigations. Many tests are often recommended and performed resulting in a significant financial burden on health care services and contributing to morbidity of these patients without prolonging survival. In 2010, guidelines were published by the National Institute of Clinical Ex...

Five Reasons Women Go For The Bad Boy

Psychology Today Relationships Center — Mon, 26 Dec 2011 14:25:38 +0100

Are the jerks ruining it for the truly nice guys? Primary Topic: Relationships read more (Source: Psychology Today Relationships Center)

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Rudolph Would Have Run Away From Santa

Scientific American - Official RSS Feed — Sun, 25 Dec 2011 16:00:00 +0100

According to holiday lore, poor Rudolph was a victim of social exclusion because he was different from the rest of the reindeer. In a move that was lucky for nice (but not naughty) children everywhere, he was then approached by Santa, who asked him to guide the sleigh. Thereafter, according to traditional sources, all the reindeer loved him. [More] (Source: Scientific American - Official RSS Feed)

NICE technology appraisals: working with multiple levels of uncertainty and the potential for bias

Medicine, Health Care and Philosophy — Sat, 24 Dec 2011 16:44:36 +0100

Abstract One of the key roles of the English National Institute for Health and Clinical Excellence (NICE) is technology appraisal. This essentially involves evaluating the cost effectiveness of pharmaceutical products and other technologies for use within the National Health Service. Based on a content analysis of key documents which shed light on the nature of appraisals, this paper draws attention to the multiple layers of uncertainty and complexity which are latent within the appraisal process, and the often socially constructed mechanisms for tackling these. Epistemic assumptions, bounded rationality and more explicitly relational forms of managing knowledge are applied to this end. These findings are discussed in the context of the literature highlighting the inherent...

IT compatibility a factor in Cone-Alamance merger

bizjournals.com Health Care:Hospitals headlines — Fri, 23 Dec 2011 19:24:10 +0100

Both Cone Health and Alamance Regional Medical Center have been responsive to the increasingly loud calls for broader implementation of electronic medical records technology. The two health systems have been ahead of the game in implementing this new technology, but their pending merger now depends in part on seeing if they can make the different systems they've chosen play nice together. During an interview this week about the merger that you can read about in today's Business Journal, Cone Health's Tim Rice and Alamance Regional's John Currin Jr... (Source: bizjournals.com Health Care:Hospitals headlines)

Department of Health letter: Children and young people's mental health- recent developments

NeLM - Mental Health — Fri, 23 Dec 2011 05:00:00 +0100

Source: Department of Health Area: News This letter issued jointly by the Chief Medical/Nursing/Pharmaceutical Officers and the NHS Medical Director highlights the publication of documents by NICE relating to improving mental health outcomes for children and young people (Source: NeLM - Mental Health)

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Adjunctive pharmacotherapies for intermittent claudication--NICE guidance

Heart — Fri, 23 Dec 2011 05:00:00 +0100

There are a number of adjunctive pharmacotherapies available for individuals with peripheral arterial disease and intermittent claudication, in whom appropriate risk factor modification and antiplatelet treatment have been initiated. These include cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate, which have vasodilatation among their mechanisms of action and have been the subject of recent technology appraisal guidance offered by the National Institute for Health and Clinical Excellence (NICE).1 The guidance offered was based upon systematic review, meta-analysis and cost-effectiveness analysis and is summarised in box 1. Box 1Summary of NICE guidelines1 For individuals with peripheral arterial disease and intermittent claudication, where vasodilator treatment is c...

NICE issues Final Appraisal Determination (rapid review of TA198) on tocilizumab for rheumatoid arthritis

NeLM - News — Fri, 23 Dec 2011 05:00:00 +0100

Source: NICE Area: News NICE has issued a Final Appraisal Determination (rapid review of TA198) on tocilizumab for rheumatoid arthritis which states that use in combination with methotrexate is recommended as a treatment option in adults if: . the disease has responded inadequately to DMARDs and it is used as described for TNF inhibitor treatments in NICE technology appraisal guidance 130 (Adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis), specifically the recommendations on disease activity and choice of treatment or . the disease has responded inadequately to DMARDs and a TNF inhibitor and the person cannot receive rituximab because of a contraindication to rituximab, or because rituximab is withdrawn because of an adverse event, a...

The holidays: Eat, drink and be wary...

USATODAY.com Health — Thu, 22 Dec 2011 21:50:59 +0100

Here's how to navigate your way around the holiday buffet table while still leaving room for being a little naughty with something nice. (Source: USATODAY.com Health)

Photocoagulation preferred treatment for DME in UK

Modern Medicine — Wed, 21 Dec 2011 05:00:00 +0100

Ranibizumab is not as cost effective as conventional laser photocoagulation for the treatment of diabetic macular edema, according to the United Kingdom’s National Institute for Health and Clinical Excellence. (Source: Modern Medicine)

Biologic agents for rheumatoid arthritis--negotiating the NICE technology appraisals

Rheumatology — Wed, 21 Dec 2011 05:00:00 +0100

In England and Wales, the National Institute for Health and Clinical Excellence (NICE) has provided guidance [technology appraisals (TAs) 130, 186, 195, 198 and 225] on the use of biologic drugs for the treatment of RA. This is based on an analysis of efficacy, safety and cost-effectiveness, and has resulted in a complex management pathway that restricts freedom to prescribe biologics according to their licensed indications. Specifically, TNF antagonists are the only class of biologics that can be used first line in DMARD-inadequate responders, and only in patients with a persistent 28-joint DAS score of ≥5.1. Alternative biologic agents are denied to those with contraindications to anti-TNF drugs and are also not supported following intolerance to TNF antagonists. Rituximab is the only...

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NICE clinical guideline and quality standard on experience of care for adults using NHS mental health services

NeLM - Guidelines — Wed, 21 Dec 2011 05:00:00 +0100

Source: NICE Clinical Guideline Area: Evidence > Guidelines NICE has published a clinical guideline (CG136) offering evidence-based advice on ensuring a good experience of care for people who use adult NHS mental health services. A quality standard describing high-quality care for adults using mental health services in the NHS in England has also been published alongside this. Please see the link below for details. (Source: NeLM - Guidelines)

Hydrolysates from wheat bran albumin as color‐adding agents and inhibitors of apple polyphenol oxidase

Journal of Food Biochemistry — Wed, 21 Dec 2011 05:00:00 +0100

ABSTRACTAlbumin from wheat bran was subjected to proteolysis. Molecular weight profile and particle size distribution were analyzed in the hydrolysates, which were later assayed in both crude extracts and surfaces of apple mesocarp in order to test their effect on polyphenol oxidase activity and enzymatic browning; the latter measured as L*, hue° and chroma*. Both the electrophoretic pattern and the size distribution showed, upon the hydrolysis, the appearance of aggregates with higher molecular weight than albumin. Polyphenol oxidase in crude extracts of apple was inhibited up to 40% by hydrolysates in a mixed way. The application of hydrolysates to mesocarp resulted in the impartment of a slight brownish color to the tissue and there were significant differences on L*, hue° and chroma*...

The use of Cochrane Reviews in NICE clinical guidelines.

Cochrane Database of Systematic Reviews — Tue, 20 Dec 2011 01:00:04 +0100

Authors: Alderson P, Tan T PMID: 22161454 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Anatomy of a Megalomaniac: Psychological Analysis of Kim Jong-il from Afar

Scientific American - Official RSS Feed — Mon, 19 Dec 2011 15:05:00 +0100

What was up with a world leader who thought he could control the weather while engaging in his passion for Elizabeth Taylor movies? No one knows for sure, but a few years ago, two psychologists took a crack at a long-distance analysis. In the September 2009 edition of Behavioral Sciences of Terrorism and Political Aggression (Editor s note: nice journal name), Frederick L. Coolidge and Daniel L. Segal tried to develop a psychological profile of the Dear Leader (in 1992 changed to Dear Father ). [More] (Source: Scientific American - Official RSS Feed)