Press Releases Saturday 31 July 1999
No 7205 Volume 319
Please remember to credit the BMJ as source when publicising
an
article and to tell your readers that they can read its full text on
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If your story is posted on a website please include a link back to
the source BMJ article (URL's are given under titles).
(1) ADVANCES
IN "ON THE SPOT" TESTS HAVE HUGE
PUBLIC HEALTH
IMPLICATIONS
(2) ELDERLY
SHOULD RECEIVE THE SAME CANCER
CARE AS
YOUNG PEOPLE
(3) EXERCISE
AND ENCOURAGING A RETURN TO
NORMAL ACTIVITIES
CAN HELP LOW BACK PAIN
SUFFERERS
(1) ADVANCES IN "ON
THE SPOT" TESTS HAVE HUGE
PUBLIC HEALTH IMPLICATIONS
(Near patient microbiological tests)
http://www.bmj.com/cgi/content/full/319/7205/298
Advances in "near patient tests" (testing
and diagnosing patients
for infection on the spot, without the
need to send samples to a
laboratory) could bring great improvements
in public health,
says Prof Peter Borriello in the week's
BMJ. The author, who
is the director of the PHLS Central Public
Health Laboratory in
London, predicts that near patient testing
kits of the future will
be able to make a diagnosis and automatically
transmit the
information to a central database as a
source of valuable
information for health policy decision
makers.
The main driving force behind the development
of near testing
kits has been the search for life in space
and the military's need
to detect biological warfare agents says
Prof Borriello. In the
future we could see remote patient testing,
he says whereby
patients swallow a small capsule that
has the ability to detect
pathogens (microorganisms that cause disease),
transmit the
data to a physician or advice centre and
which will then
transmit advice back to the patient. It
might also be possible to
connect breath analysers directly to telephones
or computers to
transmit diagnostic information, says
the author.
The benefits of near patient testing include:-
improved antibiotic
prescribing; rapid diagnosis for communicable
diseases such as
tuberculosis and acute infections such
as meningitis;
determination of whether to instigate
community contact tracing
and screening and targeting of vaccinations
to high risk groups.
The down sides of such advances also need
to be considered,
says Prof Borriello and these include:-
quality control and
assurance; misuse of kits, for example
by testing others without
their knowledge; patients using over the
counter kits in the
absence of the availability of counselling;
misinterpretation of
the meaning of positive results; deliberate
infection of others
after infection has been confirmed and
the self administration
of remedies.
Prof Borriello also suggests that the development
of kits will be
market driven and this could create a
tendency for kits to be
developed by pharmaceutical companies
to identify diseases
and infections for which they also manufacture
a treatment.
However, the most important problem of
an increase in near
testing patients could be the potential
loss of epidemiological
data - if patients test and treat themselves,
public health doctors
will not be able to ascertain the true
prevalence of diseases. He
says that the greatest challenge of near
patient testing will be to
ensure that data is captured.
Prof Borriello concludes that we should
be optimistic that the
technological development of near patient
testing kits will bring
great advances in detecting and controlling
infections.
Contact:
Prof Peter Borriello, Director, PHLS Central
Public Health
Laboratory, London
Email: Pborriello{at}phls.nhs.uk
(2) ELDERLY SHOULD RECEIVE
THE SAME CANCER
CARE AS YOUNG PEOPLE
(Cancer in old age - is it inadequately
investigated and treated?)
http://www.bmj.com/cgi/content/full/319/7205/309
Ageism in healthcare staff, lack of awareness
of treatments
available and beliefs or fears of patients
and their families about
cancer and its treatment, may all contribute
to the fact that
older patients do not receive the same
cancer care as younger
people. So say Dr Nicola Turner and colleagues
from St
James's University Hospital, Leeds in
this week's BMJ.
Although more than a third of cancers are
diagnosed in people
aged over 75 years of age, this group
is less extensively
investigated and receives less treatment
than younger patients,
say the authors. They say that this need
not be the case as
some elderly people can tolerate chemotherapy,
surgery and
radiotherapy just as well as younger patients.
A 75 year old
men and women have life expectancies of
8.5 and 11.1 years
respectively and this shouldn't be overlooked
by patients or
healthcare staff.
The team conclude that we cannot blame
the disparity of
treatment of cancer between old and young
on older people
being frail or suffering from additional
conditions. They say that
we must now ascertain which investigations
and treatments are
effective and acceptable to older people
and, in particular, find
the answers on how to manage common cancers
in old age.
Contact:
Dr Nicola Turner, Specialist Registrar,
Department of Medicine
for the Elderly, St James's University
Hospital, Leeds
Email: nicola_turner{at}talk21.com
(3) EXERCISE AND ENCOURAGING
A RETURN TO
NORMAL ACTIVITIES CAN HELP LOW BACK
PAIN
SUFFERERS
(Randomised controlled trial of exercise
for low back pain:
clinical outcomes, costs and preferences)
http://www.bmj.com/cgi/content/full/319/7205/279
A short programme of eight exercise classes
led by a
physiotherapist has been shown to help
patients to cope with
low back pain, suggests a study published
in this week's BMJ.
Dr Jennifer Klaber Moffett and colleagues
from the University
of York and University of London found
that six months after
participating in the classes, low back
pain sufferers found a
significant benefit compared with the
control group who
continued with usual primary care management.
After one year
a continuing and greater improvement in
pain and disability was
reported in the group who had attended
the classes as
compared to the control group.
The researchers studied 187 patients in
the York area, aged 18
- 60 years, who had suffered lower back
pain problems for
between four weeks and six months. Recent
management
guidelines have recommended that an early
return to physical
activities should be encouraged, but,
say the authors, patients
are often afraid that movement after an
acute onset of back
pain may be harmful.
These findings by Klaber Moffett et al
suggest that patients
who participated in the classes felt more
able to get back to
normal activities. These patients also
tended to use fewer
healthcare resources and took fewer days
off work, say the
authors.
The authors conclude that based on their
findings, this type of
exercise programme should be more widely
available.
Contact:
Dr Jennifer Klaber Moffett, Senior Lecturer,
Institute
of Rehabilitation, University of Hull,
Hull
Email: j.a.moffett{at}medschool.hull.ac.uk
FOR ACCREDITED JOURNALISTS
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Public Affairs Division
BMA House
Tavistock Square
London WC1H 9JR
(contact Jill Shepherd;pressoffice{at}bma.org.uk)
and from:
the EurekAlert website, run by the American Association for the
Advancement of Science
(http://www.eurekalert.org)
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