Two senior paediatric pathologists say they have discovered vitamin D deficiency in a significant number of children who have died of Sudden Infant Death Syndrome (SIDS)- cot deaths.The two doctors, Dr Irene Scheimberg and Dr Marta Cohen, say that vitamin D deficiency and associated diseases such as the bone disease rickets could also explain deaths that are often thought to be suspicious.

Both doctors believe their findings merit further investigation and research.

The findings in children from London and Yorkshire followed the discovery by Dr Scheimberg in 2009 of congenital rickets in a four-month-old baby whose parents had been accused of shaking him to death.

Chana Al-Alas,19, and Rohan Wray, 22, were acquitted of murdering their son Jayden after the jury learned that his fractures, supposedly tell tale signs of abuse, could have been caused by his severe rickets. Dr Scheimberg also discovered rickets in Jayden’s mother.

In London, Dr Scheimberg discovered vitamin D deficiency in a further 30 cases. Vitamin D deficiency was found to be a cause of death in three cases. Cardiomyopathy, a disease of the heart muscle, was discovered in two small babies. A third died of hypocalcemic fits, a condition of low serum calcium levels in the blood caused by vitamin D deficiency.

Vitamin D deficiency was a co-existing finding in the sudden and unexpected deaths of eight children, so-called Sudden Infant Death or Sids; in five children with bronchial asthma and another five with combined bacteria-polyviral or polyviral infections. Two of the babies, including baby Jayden, also had rib fractures.

In Yorkshire, Dr Cohen found moderate to severe levels of vitamin D deficiency in 45 children, mostly infants aged less than 12 months, who died of natural causes. Of the 24 sudden infant deaths Dr Cohen investigated from this group, 18 – or 75% – were deficient in vitamin D.

Dr Scheimberg said severe vitamin D deficiency could make the bones of small babies very brittle and capable of fracture with little or no real force.

Dame Sally Davies Chief Medical Officer was quoted as “We need to investigate the vitamin D levels of these children carefully and the circumstances in which the bones fracture,” she explained.

“Obviously if you have bones that fracture easily then they will fracture easily they will fracture with any normal movement like trying to put a baby grow on a baby you will twist their arm. In a normal child you won’t produce anything. But in a child whose bones are weakened and [who have] an abnormal cartilage growth area, then it’s easier for them to get these very tiny fractures or even big fractures.”

Vitamin D is actually a hormone, and endocrinologists are experts in how the body is regulated by the hormone excreting glands – or endocrine organs.

Stephen Nussey is professor of endocrinology at St George’s Hospital at Tooting in south London. He believes that, despite repeated government recommendations on vitamin D supplementation, vitamin D deficiency is still not being taken sufficiently seriously by the authorities.

“Lizards are quite like humans in their vitamin D. Their dietary intake is pretty low and they need to have sun exposure and you need to have a light in the enclosure in which you keep your lizard of the right wavelength.

“If you don’t have one of those lights your reptile will get osteomalacia [adult rickets] very similar to humans. I guess the RSPCA would quite rightly prosecute you if you didn’t give your reptile vitamin D.

“But there’s no action taken against you if you don’t give it to your daughter. So that rather illustrates the importance placed on vitamin D for your reptile rather than giving it to your daughter.”

Earlier this week, the chief medical officer for England, Dame Sally Davies, wrote to doctors, nurses and other health professionals advising them to consider vitamin D supplementation for certain at risk groups, including pregnant mothers.

“We know a significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood. People at risk of vitamin D deficiency, including pregnant women and children under five, are already advised to take daily supplements. Our experts are clear – low levels of vitamin D can increase the risk of poor bone health, including rickets in young children,” she explained.

“Many health professionals such as midwives, GPs and nurses give advice on supplements and it is crucial they continue to offer this advice as part of routine consultations and ensure disadvantaged families have access to free vitamin supplements through our Healthy Start scheme.

“It is important to raise awareness of this issue, and I will be contacting health professionals on the need to prescribe and recommend vitamin D supplements to at risk groups.

From: http://multi-vitamins.eu/vitamin-d-deficiencies-linked-to-cot-deaths-sids

Penicillin doses for children need to be reviewed to take account of the fact youngsters are getting heavier meaning they may not be getting an adequate dose doctors have said.Dosing guidelines have remained unchanged for almost 50 years and are mostly based on children’s ages.

But experts argue that the dose a child needs is determined by their weight – and the average weight of children has increased.

It means that children may not be receiving a big enough dose of antibiotics to combat their infection.

Giving inadequate doses also encourages bacteria to become resistant to antibiotics making them harder to treat in future, it was warned.

The average weight today of a five-year-old is 21kg and a 37kg for a 10-year-old – up to 20% higher than in 1963, researchers at King’s College London sad.

The study, led by a team at King’s College London and St George’s, University of London, said they were “surprised at the lack of recent evidence” to support current dosing recommendations for penicillins.

Writing in the British Medical Journal (BMJ), they said ‘fractions’ of adult doses are calculated instead of basing the dose on the weight of the child who needs treatment.

The article said: “The widely used doses are still based on the original dosing principle of a big child = half an adult, small child = half a big child, baby half a small child.”

The team analysed the actual dose that would be received today based on age bands recommended in the 2010/11 British National Formulary for Children and the current weights of children based on 2009 Health Survey for England data.

The results showed doses could be strikingly low.

The authors also pointed out that many infections do not need treatment with antibiotics.

“Many of the five million children in England who receive oral penicillins each year may not need them, but those who do should receive them in an effective dose.”

Dr Paul Long, senior lecturer in pharmacognosy at King’s College London, said: “We were surprised at the lack of evidence to support the current oral penicillins dosing recommendations for children, as it is such a commonly used drug.

“Children’s average size and weight are slowly but significantly changing, so what may have been adequate doses of penicillin 50 years ago are potentially not enough today.

“It is important to point out that this study does not provide any clinical evidence that children are receiving suboptimal penicillin doses that lead to harm, and we want to reassure parents of that.

“But what we are saying is that we should ensure that children with severe infections who need these antibiotics the most are still receiving an effective dose.”

The first ever National Audit of Dementia found a “shocking” lack of care delivery.It found that care was often delivered in an impersonal manner, staff ignored patients’ requests for help and staff were not trained sufficiently in the care of dementia patients despite figures showing one in four hospital beds is occupied by people with the condition.

Data from 210 hospitals in England and Wales was used in the report along with ward level data from a sample of 145 wards, over 2,000 staff questionnaires and observations of care on the wards.

Professor Peter Crome, the co-author of the report and Chairman of the National Audit of Dementia Steering Group, said that the report had “found problems across practically every aspect of care for patients admitted to hospitals with dementia.”

He added: “There were deficiencies in the assessment of people and there were deficiencies in the interaction betweem staff and patients.”

Hannah Clack from the Alzheimer’s Society called the report “shocking” and stressed the need for “a huge and radical shake-up of the way the NHS deals with people with dementia.”

She added: “People are going into hospital and they’re coming out worse in terms of their dementia and in terms of their physical health.”

The report recommended that all staff should have basic training in dementia, and that all hospitals should have Dementia Champions on every ward.

Up to 24,000 people with diabetes are dying unnecessarily every year, according to a new report.Most deaths could be avoided if they received better NHS care and if their condition was better managed, it said.

The report into death rates, from the National Diabetes Audit for England, found that women with diabetes are nine times more likely to die young than those without the condition.

Among women aged 15 to 34 with diabetes, death rates are up to nine times higher than the average for this age group.

And the report also found that two young people of both sexes aged 15 to 34 may be suffering an avoidable death every week.

An estimated 70,000 to 75,000 people with diabetes die in England every year – accounting for about 15% of all deaths.

Most deaths are related to the actual condition – diabetes can cause serious heart and kidney problems, as well as amputation of limbs and loss of eyesight.

The report said people are dying too early due to poor management of their condition.

This includes not receiving basic diabetic health checks on the NHS, having unhealthy lifestyles and not taking medication properly or understanding how to take it.

It argues that educating people in managing their condition reduces the risk that they will suffer dangerously high or low blood sugar, which increases the risk of complications but can also lead directly to death.

The gap in death rates between people with diabetes and those without become more extreme in younger age groups.

About one in 3,300 of all women will die between the ages of 15 and 34, but this risk increases nine-fold among women with Type 1 diabetes to one in 360.

Type 1 diabetes usually develops in childhood and patients need to take insulin injections.

Among women with Type 2 diabetes – linked to unhealthy lifestyles and obesity – the risk increases six fold to one in 520.

Men aged 15 to 34 in the general population have a risk of dying of one in 1,530, but this risk increases four-fold for those with Type 1 diabetes to one in 360, and by just under four-fold among those with Type 2 to one in 430.

Earlier this year the National Diabetes Audit found almost 450,000 children and younger adults (aged up to 54) with diabetes have high-risk blood sugar levels that could lead to severe complications.

The audit is managed by the NHS Information Centre and commissioned by the Healthcare Quality Improvement Partnership (HQIP).

The report also found a strong link between deprivation and increased mortality rates.

Among under-65s with diabetes, those from deprived backgrounds are twice as likely to die as those from more affluent areas.

Diabetes UK has compiled a list of 15 essential health checks and services and there are nine checks recommended on the NHS by the National Institute for Curbing Excpenditure (Nice).

These nine checks include blood sugar control, cholesterol, blood pressure, body mass index (BMI) and eye and foot examinations to check for diabetic complications.

The National Diabetes Audit has found that only around half of people (53%) with Type 2 diabetes and less than a third (32%) with Type 1 diabetes receive all nine checks.

Some 290,000 people in the UK have Type 1 diabetes and another 2.6 million are diagnosed with Type 2.

It is also estimated there are 850,000 other people with undiagnosed Type 2 diabetes.

Women can lower their risk of breast cancer by 40 per cent by following a two day ‘life saver diet’ it has been claimed.Researchers at the University Hospital in South Manchester are claiming that observing a strict two day diet, rather than trying to constantly cut calories, is a more effective way to loose weight.

The study, lead by Dr Michelle Harvie, and presented at the San Antonio Breast Cancer Symposium, found that women who followed a diet for just two days of the week lost more weight than those practising a full time diet.

The researchers put 100 overweight female volunteers on one of three diets.

The first diet consisted of consuming just 650 calories a day for several days of the week, with carbohydrates such as potatoes and bread cut out. For the remaining five days of the week the participants, whilst encouraged to eat healthily, could consumer whatever they liked.

Although volunteers on the second diet were also banned from eating carbohydrates for two days in a week, they were not set a specific calorie limit.

They were also allowed to eat as much as they wanted for the remainder of the week. The third and final group followed a more conventional diet, which included avoiding high-fat foods, alcohol and sticking to approximately 1,500 calories every day.

The results of the study showed that after three months the women on the two day diets had lost an average of nine pounds, compared to five pounds of those on the full time diet.

Volunteers who had followed the two day diet had lost nearly twice the amount of weight of those on the more traditional full time diet, and recorded significant improvements in three key areas linked to breast cancer. Their levels of hormone leptin dropped by 40 per cent.

Research professor Gillian Haddock, who also took part in the study herself, has said she would recommend the diet to friends and that she found it an easier diet option.

Mrs Haddock said: “I used to follow the 650 calorie diet on a Monday and Tuesday and it was great because I knew that by Wednesday I would be eating normally.

“It really suited me, I did it on my busiest work days and I would mainly have the milky drinks while I was at work so I didn’t have to worry about shopping or taking in a specially prepared packed lunch.”

The research, conducted at the Genesis Breast Cancer Prevention Centre at UHSM, was published in the International Journal of Obesity.

Pamela Goldberg, chief executive of the Breast Cancer Campaign said: “There are many breast cancer risk factors that can’t be controlled, such as age, gender and family history – but staying at a healthy weight is one positive step that can be taken.

“This intermittent dieting approach provides an alternative to conventional dieting which could help with weight loss, but also potentially reduce the risk of developing breast cancer.”

The diet that the women followed for only two days a week:

• Breakfast: Fruit tea and a banana, or mug of milky coffee.
• Mid-morning: Can of diet cola, or cup of tea and plum.
• Lunch: Carrot and coriander soup and half pint of milk, or salad, glass of squash and half pint of milk.
• Mid afternoon: Glass of squash, or glass of sparkling water and Satsuma.
• Dinner: Soy sauce and ginger stir-fry with two vegetables and glass of water, or vegetable curry with two vegetables, half pint of milk and cup of tea.
• Supper: Pint of milk, or hot milk with cinnamon and sweeteners.

Patients with hypertension, or chronic high blood pressure, are often given drugs to lower their risk of heart disease and stroke but the medication could also benefit a wider group of patients.Researchers found that people with prehypertension, where blood pressure is higher than normal but not as severe as in hypertension, had a 22 per cent lower risk of stroke if they took the drugs.

An analysis of 16 studies, covering 70,664 patients, found that treating 169 prehypertensive people with blood pressure-lowering medication for 4.3 years would prevent one stroke from happening.

High blood pressure is the biggest risk factor for stroke, and an estimated 40 per cent of strokes could be prevented if people took steps to control their blood pressure levels.

US data shows that about 10 per cent of Americans have prehypertension, with a blood pressure between 120/80mm Hg and 139/89mm Hg – higher than the upper boundary of “normal” but below the lower limit of hypertension.

Ilke Sipahi of the Harrington-McLaughlin Heart and Vascular Institute in Cleveland, Ohio, who led the study, published in the Stroke journal, said patients would be better off trying to lower their blood pressure through a healthy diet and physical activity than by taking pills.

He said: “We do not think that giving blood pressure medicine instead of implementing the lifestyle changes is the way to go … however, the clear-cut reduction in the risk of stroke with blood pressure pills is important and may be complementary to lifestyle changes.”

Dr Sharlin Ahmed of The Stroke Association said: “Making a few simple lifestyle choices, such as eating a healthy diet low in salt, giving up smoking, and exercising regularly can help to keep your blood pressure under control and can reduce your risk of stroke.

“As highlighted in this study, it may also be beneficial for some people with borderline high blood pressure to take blood pressure lowering medication, however this needs to be discussed with your GP.”

Professor Sir Michael Rawlins- head of the government’s medicines’ quango has said patients should sue their health trust if they are not getting the best recommended drugs.The killer quango- National Institute for Curbing Expenditure (NICE) was set up by labour to stop the NHS spending money on it’s drugs bill- so it’s unusual for him to speak out about NHS rationing.

Professor Rawlins, the chairman of NICE said the economic pressure on trusts meant that “completely illegal” decisions were being made to limit the use of expensive drugs.

He told the Financial Times: “I just wish a patient organisation would take a Trust to court for failing to comply.”

Nice has been criticised for ruling against the prescription of expensive new drugs on the grounds that they are not cost-effective.

But Sir Michael told the paper that most of Nice’s recommendations were in favour of prescription and that it was other bodies that blocked the drugs’ use.

Sir Michael criticised the local lists of approved medicines drawn up across the NHS which “second-guess” and sometimes ignore Nice recommendations.

While patient groups for particular diseases – often helped by pharmaceutical companies – have attacked Nice for advising against the use of some expensive new medicines, Sir Michael said they should be directing more criticism instead to the drug companies for charging high prices.

The government’s own innovation review recognised the problem by pledging a Nice “compliance regime” to reduce regional variation – the so-called “postcode lottery” – and to improve adherence to the agency’s guidelines.

It cautioned that local decisions should not act as a barrier to the medicines that Nice had approved.

A US company contracted to provide IT technology for the National Health Service is set to receive a £2 billion extension despite the failed project being abandoned.Computer Sciences Corporation (CSC) has reportedly informed Wall Street that it expects its contract to provide electronic patient records across the NHS to be extended.

Taxpayers are now facing an estimated £2 billion bill, despite the company already failing to deliver a fully functional version of its software, The Times reported.

The £11.4 billion National Programme for IT, set up in 2002 by bliar, was at the time spun as the world’s biggest civilian computerisation project.

It aimed to give doctors instant access to patient records wherever they were being treated and CSC had signed a deal to computerise records in most of England.

Digitising the medical records of the country’s 62 million people was the core objective of the National Programme for IT in the NHS, accounting for £7 billion of the total estimated cost.

Andrew Lansley, the Health Secretary, announced in September that he was abandoning the scheme to create a national patient database because it had “let down” the health service.

He made the decision to “urgently dismantle” the failed project after criticism it was not value for taxpayers’ money.

Yet the company stated in official US papers that it was in talks with the British Government for its contract to be extended until 2017, at a cost of up to £2 billion.

Computer applications installed as part of the scheme have also failed or been scrapped.

However, £250,000 in bonuses has been paid by the DoH to 80 people involved in the scheme as a reward for “an exceptional contribution to delivery”.

CSC, one of the world’s biggest IT providers, had been contracted to provide patient record software, known as the Lorenzo system, to 166 NHS hospitals. But it has delivered on 10 projects. None of those systems is fully functional.

CSC has signed deals worth hundreds of millions of pounds with Royal Mail, Identity and Passport Service and UK Atomic Energy Authority.

The Coalition’s Major Projects Authority, established to review Labour’s financial commitments, found the scheme was not fit to provide services to the NHS.

A cross-party committee of MPs concluded the programme had proved “beyond the capacity of the DoH to deliver”.

Katherine Murphy, of the Patients Association, said it was “shameful” to pour more money into a failed initiative.

Penny pinching NHS managers have introduced new viagra prescription guidelines which could limit thousands of couples to having sex once a fortnight.New policy documents advise GPs in parts of the country that patients in need of Viagra or similar drugs should be limited to two pills per month, down from the normal prescription of four.

Although the policy was described as a “recommendation” by NHS authorities, local medical committees told the GPs’ magazine Pulse in GPs slam secrecy over evidence for Viagra rationing restrictions it was being handed down to family doctors as an “edict”.

Erectile dysfunction medication is already stringently limited on the NHS and can only be prescribed to patients with certain conditions such as diabetes, multiple sclerosis and prostate cancer.

According to the NHS some 2.2 million prescriptions for erectile dysfunction drugs were issued last year, with 14.5 million tablets issued at a cost of about £78 million.

NHS guidance acknowledges that there “appears to be no clinical reason to restrict the number of tablets” but it adds that, according to research, the average person has sex four times a month.  The average frequency of sexual intercourse in the 40 to 60 age range is once a week.”

The new policy is aimed at economising on non-essential treatments, recommending that the minimum effective dose be prescribed “two times per month using the drug with the lowest acquisition cost.”

The guidance applies to sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis).

Richard Hoey, editor of Pulse, said: “Ask most doctors and they will say that being able to live a satisfactory sex life is a key part of health and wellbeing, but the NHS has never recognised that in its policy on treatment for erectile dysfunction.

“Limiting patients to drugs like Viagra just twice a month is to treat sex like an unnecessary luxury, and completely fails to recognise the degree of anguish it can cause some men with erectile dysfunction.”

Erectile dysfunction is very common in middle aged and older men, with an estimated 50 per cent of those between 40 and 70 experiencing the condition to some degree.

Viagra and other medications can be bought privately, but the cost of about £40 for eight pills can be prohibitive, and patients must also pay for a private prescription.

The new prescription guidelines were drawn up by South Central Priorities Committees, which covers primary care trusts (PCTs) in Milton Keynes, Oxfordshire, Berkshire East, Berkshire West and Buckinghamshire.

The Government is trying to reassure women fitted with PIP implants to prevent a rush for NHS surgery to remove faulty breast implants.The adverts, to run in a number of national newspapers at the weekend, will emphasise there is “no clear evidence” that the French made implants cause more harm than other brands.

Almost £135,000 is being spent by the Department of Health on the campaign, which will also run in social media sites. Posters will appear in GPs’ surgeries and hospitals as well.

The advert reads: “The latest advice from the NHS and plastic surgery experts is that women with PiP breast implants do not need to have them removed unless they have symptoms such as pain and tenderness.

“There is no link to cancer and there is no clear evidence of an increased risk of harm compared to other brands of breast implants.”

However, it also states, in large-type at the top of the advert: “The NHS will support women with PiP breast implants.”

Clarifying the situation for those who received implants as part of private breast enlargement operations, it states: “”The NHS will remove your implants if your doctor agrees, but the NHS will not replace implants unless it is clinically necessary.”

It advises those worried about whether they have implants made by Poly Implant Prothese (PIP), which contain industrial-grade silicone, to find out if they have them, to speak to their specialist or GP, and “agree what’s best for you”.

Despite the campaign, Fazel Fatah, president of the British Association of Aesthetic Plastic Surgeons (BAAPS), said the organisation’s stance remained that all 40,000 women fitted with them in Britain should have them removed.

He said: “We remain steadfast in our recommendation to the public of precautionary removal of these defective devices. Although there is no immediate health risk, the gel within these implants is simply not meant to be inside the human body.”

A survey of its 230 members found 95 per cent agreed that “it should be the clinics and hospitals that should pay for the replacement surgery, rather than burden the taxpayer with these costs”.

Women given the PIP implants are due to protest in London on Saturday at the reluctance of private firms like Harley Medical Group, The Hospital Group and Transform Cosmetic Surgery to fund removal and replacement surgery.

Explaining the rationale for the campaign, Andrew Lansley, the Health Secretary, said: “The refusal of some clinics to help their patients has left some of those women worried and confused.

“That’s why we are running this ad campaign, to give women clear, definitive advice about what course of action they should take. I hope it helps women decide what is best for them. We have made it very clear to private companies what we expect of them – to provide their patients with the aftercare that they need and deserve.”

“I do not think it is fair to the taxpayer or other NHS patients for the NHS to foot the bill.  We will pursue private clinics with all means at our disposal to avoid this.”

Professor Sir Bruce Keogh, NHS medical director and leader of an expert group on PIP implants convened by Mr Lansley, said: “At present there is insufficient evidence to recommend routine removal of these implants.

“But I know women will be worried. That’s why the expert group supports the NHS offer and believes the private industry should do the same.”

From: http://www.telegraph.co.uk/Breast-implant-scandal-Government-campaign-to-reassure-women