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(2) TOO
FEW DOCTORS KNOW HOW TO
RESPOND TO
A TERRORIST ATTACK
(3) ALL BAT HANDLERS SHOULD GET RABIES JAB
(1) NEW CERVICAL
SMEAR TESTS PERFORM NO
BETTER THAN CONVENTIONAL TESTS
(Cross sectional study of conventional
cervical smear,
monolayer ctology, and human papillomavirus
DNA
testing for cervical cancer screening)
http://bmj.com/cgi/content/full/326/7392/733
New cervical smear tests are unreliable
and should not
replace conventional tests (PAP smears)
according to a
study in this week's BMJ.
Researchers in France studied 828 women
referred to
hospital because abnormalities had been
detected on
previous smears and 1,757 women attending
for routine
smears.
Each woman underwent a conventional cervical
smear
test. The remaining material was then
tested using two
new methods (monolayer cytology and human
papillomavirus testing). These tests are
replacing
conventional smear tests in several countries.
Conventional cervical smear tests were
more often
satisfactory and had consistently better
sensitivity and
specificity than monolayer cytology. Human
papillomavirus testing performed no better
than
conventional smear tests.
These results support the superiority of
conventional
smear testing, and have implications for
regulation of
medical devices, clinical practice, and
future research on
screening for cervical cancer, say the
authors. They also
emphasise the need to improve the "hard
evidence" in
studies of new technologies.
Monolayer testing is less reliable and
more expensive
and should not replace conventional smear
tests for
cervical cancer screening, while human
papillomavirus
testing should be further evaluated, they
conclude.
Contacts:
Philippe Vielh, Pathologist, President
of the French
Society of Clinical Cytology, Institut
Curie, Paris, France
Email: philippe.vielh@curie.net
Joël Coste, Professor of Medical Statistics,
Publique-Hôpitaux de Paris, Faculté
de Médecine
Cochin-Port Royal, Université Paris
V, France
Email: coste@cochin.univ-paris5.fr
(2) TOO FEW DOCTORS
KNOW HOW TO
RESPOND TO A TERRORIST ATTACK
(Letter: Medical staff need to be
aware of major incident
planning)
http://bmj.com/cgi/content/full/326/7392/762
Not enough medical staff are aware of their
role in the
event of a terrorist attack, according
to a letter in this
week's BMJ.
Researchers surveyed 107 doctors in North
Bristol
NHS Trust about the local major incident
plan. All these
doctors would have a role in the mobile
medical team if
they were on duty during a major incident.
Of the 77 doctors who replied, 69 were
aware of the
existence of the plan, but only 26 had
read part or all of
it. Only 11 of the responding doctors
were aware of
their potential role in the mobile medical
team.
Of these 11 doctors, only three thought
themselves
adequately trained for this position,
and all three had
been trained as medical incident officers.
"As a trust we are currently considering
several measures
to improve on our results," say the authors.
"We suspect,
however, that our findings are not unique
and encourage
other acute trusts to look closely at
their staff's
knowledge and training and act accordingly,"
they
conclude.
Contact:
Press Office, Frenchay Hospital, Bristol,
UK
(3) ALL BAT HANDLERS SHOULD GET RABIES JAB
(Editorial: Bat rabies)
http://bmj.com/cgi/content/full/326/7392/726
All bat handlers in the United Kingdom
should be
immunised against rabies, following the
death of a bat
conservationist in Scotland last year,
according to an
expert in this week's BMJ.
In the UK, classic rabies was eliminated
from the animal
reservoir in the 1920s, writes Derrick
Pounder,
Professor of Forensic Medicine at the
University of
Dundee. Last year's death was caused by
a closely
related virus and was the first fatality
since 1902 from
rabies acquired in the UK.
Bat rabies virus has been found in two
bats in the UK.
Both infected bats found were Daubenton's
bats, one of
16 bat species resident in Britain. They
rarely roost in
houses and rarely come into contact with
people, so the
risk of a member of the public coming
into contact with
an infected bat seems very low, says the
author.
However, more than 1000 volunteers in Britain
are
handling bats regularly for conservation
and welfare and
therefore should all be immunised against
rabies.
Other occupations or recreational activities
bringing
people into close contact with bats might
also justify
immunisation, he adds. Currently available
vaccines are
safe and effective against both bat viruses
and the classic
rabies virus.
Contact:
Derrick Pounder, Professor of Forensic
Medicine,
Department of Forensic Medicine, University
of Dundee
Email: d.j.pounder@dundee.ac.uk
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