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Press releases Saturday 9 December 2006
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(1) YOUNG INFANTS SHOULD NOT BE LEFT UNATTENDED TO SLEEP IN CAR SAFETY SEATS
(2) WOMEN NEED NOT WAIT TO CONCEIVE AFTER BREAST CANCER
(3) HAJJ PILGRIMS SHOULD GET FLU JAB TO AVOID PANDEMIC
(1) YOUNG INFANTS SHOULD NOT BE LEFT UNATTENDED TO
SLEEP IN CAR SAFETY SEATS
(Apparently life threatening
events in infant car safety seats)
http://bmj.com/cgi/content/full/333/7580/1205
(Editorial: Child safety in
cars)
http://bmj.com/cgi/content/full/333/7580/1183
Young infants should not be left unattended to sleep in standard car safety seats, warn researchers in this week’s BMJ.
Infant car safety seats are vital to protect young infants from injury and death in motor vehicle accidents, write Professor Alistair Gunn and Colleagues.
However, preterm infants and full term infants with certain health conditions are at risk of oxygen de-saturation and apnoea (temporary suspension of breathing) while they are restrained in recommended semi-reclining infant car seats. Studies have also shown that mild oxygen de-saturation can affect some full term infants, although others found no effect.
To investigate this further, researchers in New Zealand examined infants referred to the Auckland Cot Monitoring Service between July 1999 and December 2000 after an apparently life threatening event.
Nine infants (aged 3 days to 6 months) had been left to sleep restrained in a car safety seat appropriate for their age. One infant was preterm; the remainder were full term and all infants were completely normal on examination.
Infants were described as “blue,” “scrunched up” and “not breathing” when the events occurred.
When the scene was reconstructed, using the infant’s own car seat, their heads bent forward with the jaw pressed down on the chest. This led to a narrowing of the upper airway and breathing problems.
All infants were given breathing monitors and the parents were given advice on appropriate positioning, including not leaving the infant for excessive periods in the car seat. None of the infants had any further reported problems over the next 12 months.
The frequency of leaving sleeping infants in car seats is low, say the authors. However, modifying car safety seats so that head does not bend forward could avoid the risk of these events. Half the mothers in this study were smokers, which may also have had an effect, they add.
Child safety in cars is also the topic of an editorial in this week’s BMJ.
When used properly, child passenger restraints reduce injury by 90-95% for rear facing systems and 60% for forward facing systems compared with not using a restraint, writes Michael Hayes of the Child Accident Prevention Trust.
He welcomes new UK legislation on carrying babies and children in vehicles, but points out that child restraints and seat belts are secondary safety measures and do not prevent car crashes. Prevention should continue to be the long term aim, he concludes.
Contacts:
Alistair Gunn, Associate Professor,
Departments of Physiology and Paediatrics, University of Auckland, Auckland,
New Zealand
Email: aj.gunn@auckland.ac.nz
Editorial: Michael Hayes, Projects
Director, Child Accident Prevention Trust, London, UK
Email: mike.hayes@capt.org.uk
(2) WOMEN NEED NOT WAIT TO CONCEIVE AFTER BREAST CANCER
Online First
(Pregnancy after breast cancer: population based study)
http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.39035.667176.55
Young women who are diagnosed with breast cancer need not wait the recommended two years after treatment before attempting to conceive, says a study published on bmj.com today.
Women of childbearing age who are diagnosed with breast cancer are currently advised to wait at least two years after treatment to become pregnant. This is mainly to identify those who relapse early and have a poor prognosis, but there are no published data to suggest that postponing conception will affect the outcome of the cancer or pregnancy. In fact, some studies have implied that subsequent pregnancy may provide a survival benefit.
So researchers in Western Australia set out to investigate the effects of pregnancy after breast cancer.
They identified 123 women aged 15-44 who were diagnosed with breast cancer and had at least one pregnancy after their diagnosis. The average age at first subsequent pregnancy was 35.
Sixty two (50%) women conceived within two years of their diagnosis (29 of them had an abortion, 27 had a live birth, and six miscarried). More abortions occurred in the first six months after breast cancer was diagnosed and while the woman was undergoing active treatment.
Women who became pregnant had improved overall survival compared with those who didn’t. This protective effect was seen for women who waited at least six months to become pregnant, but it was stronger (statistically significant) among women who waited two years after treatment.
This study does not support the current medical advice given to premenopausal women diagnosed with breast cancer to wait two years before attempting to conceive, say the authors.
This recommendation may be valid for women who are receiving treatment or have systemic disease at diagnosis, but for women with localised disease, early conception after completion of their treatment is unlikely to adversely affect their survival, they conclude.
Contact:
Angela Ives, Doctoral Scholar, School of Surgery and Pathology, University of Western Australia Tel (please note this is +9 hrs GMT): +61 8 9346 3628 Mobile: +61 418 917 956 Email: angela.ives@uwa.edu.au
(3) HAJJ PILGRIMS SHOULD GET FLU JAB TO AVOID PANDEMIC
(Editorial: Hajj and the risk
of influenza)
http://bmj.com/cgi/content/full/333/7580/1182
(Letter: Influenza vaccine
uptake among British Muslims attending Hajj)
http://bmj.com/cgi/content/full/333/7580/1220
Flu vaccination should be mandatory for all Hajj pilgrims to minimise the risk of a global pandemic, say doctors in this week’s BMJ.
At the end of next month Saudi Arabia will again host the Hajj – the largest annual gathering in the world – which attracts more than two million pilgrims from almost every country on earth.
For the individual pilgrim this is a deeply spiritual journey, but from a public health perspective, such a gathering makes the possible rampant spread of the influenza virus and a global pandemic a potentially devastating prospect that has been inadequately prepared for, write Professor Aziz Sheikh and colleagues.
Overcrowding is considerable throughout Hajj and it has been estimated that more than one in three pilgrims will experience respiratory symptoms during their stay.
Although the Saudi authorities recommend flu vaccination for pilgrims with chronic illnesses, data show that many high risk pilgrims remain unimmunised. For example, in a letter to this week’s BMJ, researchers found worryingly low rates of vaccination among British Muslims attending Hajj in 2005 and 2006.
And the situation is probably far worse among the large numbers of people coming from the economically developing world, add the authors.
Given this fact and the risks of a pandemic originating from the Hajj, mandatory influenza vaccination for all pilgrims should be considered, they write. Meningococcal vaccination for Hajj is already mandatory, so this extra vaccination should not be too inconvenient and should be readily acceptable.
Virus surveillance to identify newly emerging strains is also urgently needed, they say.
The World Health Organisation must work with the Saudi authorities to minimise the risk of the influenza virus spreading among pilgrims (and the rest of us). A coherent international response will be needed to ensure that the resources and logistics are in place so that these strategies can be implemented, they conclude.
Contacts:
Editorial: Aziz Sheikh, Professor
of Primary Care Research and Development, Allergy and Respiratory Research
Group, Division of Community Health Sciences, University of Edinburgh, Scotland
Email: aziz.sheikh@ed.ac.uk
FOR ACCREDITED JOURNALISTS
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SquareLondon WC1H 9JR
(contact: pressoffice@bma.org.uk)
and from:
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