This week in the BMJ
Volume 329, Number 7458, Issue of 17 Jul 2004The NHS could offer screening for colorectal cancer
The NHS could offer screening for colorectal cancer
Screening for colorectal cancer within the NHS is feasible. In a demonstration pilot, the UK Colorectal Cancer Screening Pilot Group (p 133) used faecal occult blood testing to screen 478 250 people aged 50-69 living in England and Scotland. They found that 57% of those invited took part; 1.9% had positive results, and the rate for detecting cancer was 1.62 per 1000 people screened. The cost of screening was about £5900 per life year saved. Offering screening to everyone will require an increase in provision of endoscopy services, the authors say.
|
![[To top]](/icons/back.gif){kind=icon}
Agreeing a treatment plan cuts hospital detentions
Joint crisis plans reduce compulsory admissions to hospital in people with mental illnesses. Henderson and colleagues (p 136) randomised 160 people with psychotic illness or non-psychotic bipolar disorders from southern England to the intervention, which consisted of the patients and health carers—in negotiation with a third party—agreeing a plan on how to deal with a crisis, or to standard care. They found that having an advance agreement led to a considerable reduction in use of the Mental Health Act for compulsory admission and treatment.
Poorer women are more likely to have advanced breast cancer at diagnosis
Women living in deprived areas are more likely to have high grade or advance stage breast cancer at the time of diagnosis. Reviewing data on 12 793 women with breast cancer from the Northern and Yorkshire Cancer Registry and Information Service, Adams and colleagues (p 142) found that 13% had advanced cancer stage at diagnosis, and 31% had high grade cancer. The socioeconomic trends were stronger in women potentially exposed to the breast cancer screening programme.
Doctors do not use the Apgar score well
Doctors do not apply criteria for Apgar scoring consistently. Lopriore and colleagues (p 143) asked 166 paediatricians in the Netherlands to apply the Apgar score to three hypothetical presentations of newborns. They found no uniformity in scoring among doctors, particularly in assessment of respiratory efforts in intubated newborn babies. Paediatricians should follow Apgar's original definition more strictly, say the authors, and consensus on scoring intubated babies should be reached.
Blood pressure of Irish teenagers has fallen
The blood pressure of adolescents in Northern Ireland decreased between 1990 and 2000. Analysing data from the Young Hearts studies, Watkins and colleagues (p 139) found that blood pressures in 12 year olds and 15 year olds decreased 7.7-11.0 mm Hg. These findings were not explained by changes in body composition or by birth weight. If the decrease is sustained in adulthood, say the authors, the public health benefits are likely to be considerable.
|
Home control of blood pressure is beneficial
Monitoring blood pressure at home improves control of hypertension. Reviewing 18 trials on 2714 patients, Cappuccio and colleagues (p 145) found that hypertensive patients who had had home blood pressure monitoring had lower systolic, diastolic, and mean blood pressures than those who had had standard blood pressure control in the clinic. Those monitoring blood pressure at home were less likely to have blood pressures above predetermined targets than those whose pressure was checked only in clinics.
Ring fencing reduces hospital infection
A simple infection control strategy may reduce postoperative infections in orthopaedic patients. Biant and colleagues (p 149) analysed the effect of ring fencing of beds, screening for methicillin resistant Staphylococcus aureus (MRSA) before admission, and a code of dress and behaviour on the orthopaedic ward in a district general hospital in Essex. After implementation of the strategy, postoperative infection decreased significantly; no new cases of MRSA infection occurred; and 17% more patients were treated without increasing the numbers of surgeons, beds, or operating sessions.
|
What's new
Keep updated
Services
Tools
Online poll
Resources
Print issues
