Tuesday, 25 December 2012

Simple eye scan can reveal extent of Multiple Sclerosis

The retina sits at the back of the eye and houses the cells that provide us with vision

A simple eye test may offer a fast and easy way to monitor patients with multiple sclerosis (MS), medical experts say in the journal Neurology.

Optical Coherence Tomography (OCT) is a scan that measures the thickness of the lining at the back of the eye - the retina.

It takes a few minutes per eye and can be performed in a doctor's surgery.

In a trial involving 164 people with MS, those with thinning of their retina had earlier and more active MS.

The team of researchers from the Johns Hopkins University School of Medicine say larger trials with a long follow up are needed to judge how useful the test might be in everyday practice.

The latest study tracked the patients' disease progression over a two-year period.

Unpredictable disease

Multiple sclerosis is an illness that affects the nerves in the brain and spinal cord causing problems with muscle movement, balance and vision. In MS, the protective sheath or layer around nerves, called myelin, comes under attack which, in turn, leaves the nerves open to damaged.

There are different types of MS - most people with the condition have the relapsing remitting type where the symptoms come and go over days, weeks or months.

Usually after a decade or so, half of patients with this type of MS will develop secondary progressive disease where the symptoms get gradually worse and there are no or very few periods of remission.

Another type of MS is primary progressive disease where symptoms get worse from the outset.

There is no cure but treatments can help slow disease progression.

It can be difficult for doctors to monitor MS because it has a varied course and can be unpredictable.

Brain scans can reveal inflammation and scarring, but it is not clear how early these changes might occur in the disease and whether they accurately reflect ongoing damage.

Scientists have been looking for additional ways to track MS, and believe OCT may be a contender.

OCT measures the thickness of nerve fibres housed in the retina at the back of the eye.

Unlike nerve cells in the rest of the brain which are covered with protective myelin, the nerve cells in the retina are bare with no myelin coat.

Experts suspect that this means the nerves here will show the earliest signs of MS damage.

The study at Johns Hopkins found that people with MS relapses had much faster thinning of their retina than people with MS who had no relapses. So too did those whose level of disability worsened.

Similarly, people with MS who had inflammatory lesions that were visible on brain scans also had faster retinal thinning than those without visible brain lesions.

Study author Dr Peter Calabresi said OCT may show how fast MS is progressing.

"As more therapies are developed to slow the progression of MS, testing retinal thinning in the eyes may be helpful in evaluating how effective those therapies are," he added.

In an accompanying editorial in the same medical journal that the research is published in, MS experts Drs Robert Bermel and Matilde Inglese say OCT "holds promise" as an MS test.

Sunday, 23 December 2012

'I have plenty of people to do things with, I just have no one to do nothing with

Lonely Britain

When Esther Rantzen wrote in the Mail about her aching loneliness, she broke a great social taboo. The huge and heartfelt response she received paints a devastating portrait

By Esther Rantzen
UPDATED:10:27, 13 October 2011

A few weeks ago, I wrote (with some trepidation, I must confess) about the aching loneliness that sometimes overwhelms me. How I often wake at midnight still lying on the sofa, the TV blaring and lights blazing, and have to force myself to my empty bed.

I admitted that now I have been a widow for ten years, with grown-up children who have busy lives of their own, I dreaded the empty weekends and didn’t go on holiday this year because it seemed pointless to go somewhere gorgeous without anyone to share it with.
Worst of all, I confessed I had started pressurising my daughter to give up her independence and move in with me. I didn’t expect much sympathy.

All by myself: But Esther discovered she isn't alone in feeling lonely

After all, as a famous novelist once declared: ‘Forget sex or politics or religion: loneliness is the subject that clears out a room.’
But then a strange thing happened. Of all the articles and books I have written, the subject provoked by far the greatest response. I was inundated with letters and emails — some expressing sympathy, others advice, but most sharing their own tales of aching isolation.
It was only as I read them that the scale of this epidemic of loneliness in Britain started to become clear to me.
Their stories chimed with a shocking report earlier this month from a group called the Campaign To End Loneliness, focusing, in particular, on the ‘pernicious impact’ of isolation on older people.

More...

It included the startling fact that, according to the World Health Organisation, loneliness poses a huge health risk — even more, they say, than smoking. The report estimates that loneliness ‘blights the lives of about one in ten older people’.
So what lessons can be learned from the many, often moving, responses I received?
The first is that loneliness is a subject we need to talk about, because unless we do, we can never solve it. And solve it we must. Because what was most clear from your letters is that loneliness is all around us, yet too often it remains invisible.

'Loneliness has a shaming quality born out of the perception of social failure. It is an ache that dares not speak its name'

Loneliness does not respect gender or age. And money in the bank is certainly no defence against it. Young and old have written to me, divorcees and disabled people, widowers and many, many widows, because, alas, we women tend to outlive the men we love.
But we don’t talk about it because loneliness bears its own stigma. Many correspondents wrote about the ‘shame’ they felt, and how ‘brave’ and ‘honest’ I had been, and in their letters they revealed just how much of a taboo there is in admitting that you feel lonely.
In fact, one friend was angry with me for writing about my predicament. ‘How could you, Esther? Don’t you have pride?’ he said.
Another friend neatly summed up why people don’t admit to loneliness.
He told me: ‘Loneliness has a shaming quality born out of the perception of social failure. It is an ache that dares not speak its name for fear that people will think us needy, and so will shun us like an empty restaurant.’
As a result, it seems there are many people who prefer to disguise their loneliness and put on a brave face to the wider world and even to their families.
‘J’ from Surrey wrote to me: ‘When I was first widowed, I told my family I was “fine” so they were able to go back, as they should, to their busy lives. By trying not to make a fuss, though, we may have shot our ourselves in the foot!’
But sharing our feelings, and knowing you are not the only one to experience this, is a source of comfort.

Esther didn't like to talk about loneliness because it bears its own stigma

I searched among your letters for the cure for loneliness. But for many, there is no complete cure. No one can bring back the love they have lost, or fill the empty rooms.
Instead, I found many suggestions about ways to alleviate the symptoms; something as simple as keeping the radio on, or buying a puppy, or learning new skills. Many who wrote had forced themselves to be proactive and were now reaping the benefits.
Pat Woods, aged 68, from Lincoln, said that after she lost her husband Alan, she knew no one would walk up her garden path and take her under his wing — ‘so I decided I had better try to do something myself.
‘I had a cheese-and-wine evening, and invited ten widows. Like you, I thought weekends were dreadful, and so I suggested that on the first Sunday of the month we should take it in turns to meet at each other’s homes.

'I have plenty of people to do things with, I just have no one to do nothing with'

‘That was five years ago, and we are now 22-strong. We have visited Crete, Krakow and Berlin, and London for the theatre.
‘We have enormous fun, much laughter, and when you are feeling low, there is always someone there who understands.’
Margaret Bell, from Tonbridge, had a similar inspiration. Four years ago, she and two friends started up CAMEO (Come And Meet Each Other) — and they do, 40 men and women. Most of them are bereaved, but not all.
‘We manage to find at least 12 things a month to do: Sunday lunches, films, shows, walks, minibus outings, plays, concerts,’ she told me.
‘Last year, 11 of us went on our first CAMEO holiday to Scotland, which was such a success that this year, 15 of us went to the Isle of Wight.’
Of course, there are existing organisations that can fill the gap for some people. The Church is widely praised, as are the Women’s Institute and the Townswomen’s Guild. Institutions like these are ones we should treasure.
But, for others, activities are not enough to ease the sense of isolation. And it’s especially so for those, like me, who lose a soulmate.
My husband Desmond Wilcox died in 2000 after 23 years of marriage. I have plenty of work to distract me, but my home is dark and empty when I return at night.
As the legendary journalist Felicity Green once said: ‘I have plenty of people to do things with, I just have no one to do nothing with.’

Empty home: Being without husband Desmond Wilcox is the worst part of Esther's loneliness

Mary Simpson emailed me to say that for her, loneliness is like being trapped in ‘quicksand’. Advice on pulling herself together is useless , she said, because as she struggles, she just feels she falls deeper into it.
I know only too well that for some of us the loss of that life partner — the warmth, the laughter, the sharing — is the sharp edge that draws blood. Having experienced that closeness, you miss it desperately.
While some are lucky to meet new partners, many don’t. And I don’t think there’s any easy solution, except perhaps to learn to count your blessings.
As I read the kind, brave letters I received, I felt as if I’d suddenly found a new community of friends.
But some, of course, have taken me to task. They rebuke me for not appreciating how lucky I am to have my health and my family.
I do know that. And I am hugely fortunate to own a cottage in the country, with a lovely garden that Desmond created with me.
Jacqueline Norris from Farnborough points out that I’m daft just to sit at home fixing myself the single person’s constant meal of cheese and biscuits.
‘You say you have a country cottage — so use it!’ she reprimands. ‘Marvel at nature. And do cook for yourself – just something simple. You will enjoy the preparation — and the satisfaction of being able to tell the family what you’ve enjoyed.’

‘My greatest fear is being regarded as a burden on anyone’

You inspired me, Jacqueline, to make an enormous beef casserole. The blessed thing lasted a week, but I did find myself enjoying it until the third day. Next time, having learned from that experience, I may halve the quantities.
Eighty-three-year-old Pat, an ex-nurse, told me kindly but briskly: ‘Esther, count your blessings and go and volunteer. Go to bed tired and feed yourself properly.’
Olive, from Romsey, was tougher. She says she was ‘incensed’ by my attitude. She roundly declared: ‘I am now 87 and am aware every day of my good fortune. At Esther’s age, I holidayed alone, walked and enjoyed my garden. Grow up, Esther.’
Responses like these stiffened my spine; these women are so uncomplaining and courageous. Then a lady from Pembrokeshire stirred my conscience when she told me I didn’t ‘know the first thing about loneliness’.
She asked me not to print her name — because ‘it makes me ashamed to admit these things’ — so I will call her Sheila.
‘Your whinge about loneliness made me angry,’ Sheila, 77, wrote. ‘I have been alone in a cottage in this tiny village since my beloved husband died eight years ago.
‘Unlike you, I have no children, no siblings, no parents or relatives at all, and my friends are either dead or far-flung.
‘The village is full of families who are entirely insular, which is understandable; but there have been times when I have not spoken to anyone for weeks, especially as I am often ill. I have survived cancer and a broken hip.

‘Another difference: you have money in the bank. You could cruise every month, and as you can talk for England, I doubt you’d remain lonely for long.’
Sheila belongs to the growing numbers of older people who are imprisoned in disability and poverty, and it is their plight that inspired the Campaign to End Loneliness, which was launched earlier this year, backed by four national charities.
The report accompanying the campaign stressed that loneliness is more than just socially embarrassing. It’s the ‘hidden killer’ of the elderly, because those who suffer ‘intense’ loneliness are at increased risk of depression, bad eating habits and poor physical health from lack of exercise.
And they predict it will only become more acute in the future as people live longer and families become more disparate and dispersed.
According to Dr Ishani Kar-Purkayastha, writing in the Lancet, there are already too many ‘men and women who are not yet done with being ferocious and bright, but for whom time now stands empty as they wait in homes full of silence; their only mistake to have lived to an age when they are no longer coveted by a society addicted to youth’.
But as the campaign highlights, loneliness can be conquered if there is the will to recognise it, if we battle against the stigma and work to overcome it.
While the internet and the telephone may be useful tools for communicating, we need to treasure the opportunities we get for ‘a chat and a cuppa’.

WHO KNEW?

A survey found 60 per cent of those aged 18 to 34 spoke of feeling lonely often or sometimes, compared with 35 per cent of those aged over 55

It costs so little, yet achieves so much. As the campaign says: ‘Wherever they arise, we should be protecting and extending these routine and inexpensive ways of keeping people connected.’
And best of all, as one interviewee told the charity Age UK: ‘You don’t need a Criminal Records Bureau check to be a good neighbour.’
So I will treasure the huge bundle of letters I have received from people who have so much vitality and vision. And they have prompted me to make some new resolutions myself.
I will attend the campaign’s forthcoming conference on tackling loneliness, which they are organising in a month’s time, to hear of other groundbreaking projects around the country designed to bring people together.
I will also explore ways of using television to tackle this issue, because it is crucial to our physical and our emotional health.
And I will consider an idea put to me by Ada, an old friend who is now in her 80s and has been on her own for 31 years since her husband died.
‘Esther,’ she said, ‘you need a companion, and you need more exercise. The answer’s simple. Buy yourself a rescue dog.’
Good idea, Ada. The dog and I may, after all, be rescuing each other.

I may seem to have it all - but I yearn for human contact

Sarah Bolitho lives in Cardiff and helps the disabled and the elderly to keep fit.
‘On the surface, I have everything,’ says 53-year-old Sarah. ‘A successful career, a beautiful flat, good looks for my age and self-confidence. But underneath, I am extremely lonely.
‘I have been married and divorced twice, and I live far from my family. My daughter and granddaughter live in Durham, and my sons live in London.

Sarah Bolitho has been divorced twice and lives far from her family

‘And although professionally I’m very confident, personally I’m painfully shy. I think I rushed into both of my marriages. The first lasted 13 years and the second six years. Now I’m scared to start another relationship.
‘I don’t see much of my sister, as she is very busy with her own life.
‘Similarly, my friends have families of their own — and I’m reluctant to intrude.
‘I’d love to have someone to go to films or the theatre with, but I’m too shy to pick up the phone.
‘Recently I bought two tickets for the theatre, but I couldn’t find anyone to come with me, so I ended up going on my own.
‘My greatest fear is being regarded as a burden on anyone.

Read more: http://www.dailymail.co.uk/femail/article-2048488/Lonely-Britain-When-Esther-Rantzen-wrote-Mail-aching-loneliness-received-overwhelming-response-heartfelt-understanding.html#ixzz2FsCEbDTO
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Wednesday, 19 December 2012

Patients with advanced Parkinson's disease often have rapid swings between mobility and immobility

Subthalamic nucleus versus globus pallidus bilateral deep brain stimulation for advanced Parkinson's disease (NSTAPS study): a randomised controlled trial

Summary

Background

Patients with advanced Parkinson's disease often have rapid swings between mobility and immobility, and many respond unsatisfactorily to adjustments in pharmacological treatment. We assessed whether globus pallidus pars interna (GPi) deep brain stimulation (DBS) gives greater functional improvement than does subthalamic nucleus (STN) DBS.

Methods

We recruited patients from five centres in the Netherlands who were aged 18 years or older, had idiopathic Parkinson's disease, and had, despite optimum pharmacological treatment, at least one of the following symptoms: severe response fluctuations, dyskinesias, painful dystonias, or bradykinesia. By use of a computer-generated randomisation sequence, we randomly assigned patients to receive either GPi DBS or STN DBS (1:1), applying a minimisation procedure according to drug use (levodopa equivalent dose <1000 i="i" mg="mg" nbsp="nbsp">vs

≥1000 mg) and treatment centre. Patients and study assessors (but not those who assessed adverse events) were masked to treatment allocation. We had two primary outcomes: functional health as measured by the weighted Academic Medical Center Linear Disability Scale (ALDS; weighted by time spent in the off phase and on phase) and a composite score for cognitive, mood, and behavioural effects up to 1 year after surgery. Secondary outcomes were symptom scales, activities of daily living scales, a quality-of-life questionnaire, the occurrence of adverse events, and drug use. We used the intention-to-treat principle for all analyses. This trial is registered with www.controlled-trials.com, number ISRCTN85542074.

Findings

Between Feb 1, 2007, and March 29, 2011, we enrolled 128 patients, assigning 65 to GPi DBS and 63 to STN DBS. We found no statistically significant difference in either of our primary outcomes: mean change in weighted ALDS (3·0 [SD 14·5] in the GPi group vs 7·7 [23·2] in the STN group; p=0·28) and the number of patients with cognitive, mood, and behavioural side-effects (36 [58%] of 62 patients in the GPi group vs 35 [56%] of 63 patients in the STN group; p=0·94). Secondary outcomes showed larger improvements in off-drug phase in the STN group compared with the GPi group in the mean change in unified Parkinson's disease rating scale motor examination scores (20·3 [16·3] vs 11·4 [16·1]; p=0·03), the mean change in ALDS scores (20·3 [27·1] vs 11·8 [18·9]; p=0·04), and medication (mean levodopa equivalent drug reduction: 546 [SD 561] vs 208 [521]; p=0·01). We recorded no difference in the occurrence of adverse events between the two groups. Other secondary endpoints showed no difference between the groups.

Interpretation

Although there was no difference in our primary outcomes, our findings suggest that STN could be the preferred target for DBS in patients with advanced Parkinson's disease.

Funding

Stichting Internationaal Parkinson Fonds, Prinses Beatrix Fonds, and Parkinson Vereniging.

Ambitious about Autism guide

Tips for an autism-friendly Christmas

Emma Tracey | 15:01 UK time, Friday, 14 December 2012

Dylan and Jake Beadle in the snow with mum Tracy

Most of us see Christmas as a welcome excuse to break from the old routine, do lots of socialising and give and receive presents. But the holidays can prove challenging for children and adults on the autistic spectrum, who find change, crowds and surprises difficult to handle.

That's why Ambitious about Autism and the National Autistic Society have both thought to produce their own online guides to help people with ASD, and their families, to cope with Christmas time.

Tracy Beadle, mother of two children who are on the autistic spectrum, is one of the contributors to the Ambitious about Autism guide which has been crowd-sourced via social media and their Talk about Autism forums.

Her sons, seven-year-old Dylan Beadle and his four-year-old brother Jake both love Christmas but their social difficulties, sensitivities about touch, taste and noise, and untypical reactions to certain situations, have led mum Tracy and dad Glen to approach this part of the year a little differently.

Christmas preparations start for the family in late November to get Dylan and Jake ready for changes at home.

"We give the boys a count down of 'sleeps' before the decorations go up, and then again before they come down," Tracy says.

"A visual calendar is then hung in their bedroom and every night we stand and count the sleeps until Christmas Day."

The calendar is a sheet of paper with a square representing each day. All other squares are blank apart from Christmas Day which has present-bedecked stickers on it.

Both of the online guides appreciate that all children are different, so what works for one may not suit another.

The National Autistic Society suggests that some might benefit from having more events marked on their visual calendar, such as when the school holidays begin and end, when they can expect visitors and so on.

Finding out when preparation will begin at your child's school and then starting your family Christmas at home at the same time is another suggestion.

One Christmas inevitability for children is the annual school performance. Tracy's eldest son Dylan isn't a fan. "He has cried his way through the last three, so he isn't going to take part this year. It upsets him and it isn't an essential life skill."

Younger son Jake hopes to be in his school nativity play but Tracy says this took some work: "He went mad when he saw his shepherd's outfit, and said 'I go to school as a boy, not a shepherd'."

They took the costume in to school and introduced Jake to it slowly. He had learned the songs and was eager to go on stage, so after some encouragement from the teacher, Jake has been convinced to wear the robes during the show.

A fear of people in costume means that visiting Santa is not part of the Beadles' Christmas routine.

"We took Dylan once," Tracy remembers. "He was the only child there who, instead of sitting on Santa's lap, sat on a toy car and started playing with it. He wouldn't speak to Santa at all."

Like many others with autism, Jake and Dylan aren't good at faking delight if they get an unwanted gift. Friends and relatives now always ask mum and dad what the boys would like. For Tracy, this is an easy one to answer.

"They do tend to have an obsession each Christmas," she says. "It is Angry Birds this year. Last year it was Disney's Cars."

Tracy is aware of parents who discourage their autistic child's obsessions but she takes a different approach. "I completely over-indulge the obsessions, buying them every toy they want because I find that if you over-indulge them, it passes more quickly."

Both guides have plenty of tips for managing Christmas Day. Advice includes putting batteries in toys in advance so that they can be played with straight away and making sure that the Christmas meal is ready at a prearranged time.

The consensus, though, is to find a routine that works and stick to it. Through trial and error, Tracy and Glen Beadle have found a pattern of events which the boys like and which they expect to happen. So, what's their pattern?

"On Christmas Eve we go to visit my nan," says Tracy. "On the way home we take them to visit a house with thousands of pounds worth of decorations. On Christmas Day, we open presents and then my immediate family come for dinner."

You can follow Ouch! on Twitter and on Facebook.

Tuesday, 18 December 2012

Pharmacies caught illegally selling addictive drugs

Nine pharmacists accepted cash for prescription-only medicines

Pharmacies caught illegally selling addictive drugs to undercover reporters face three separate investigations - including a criminal probe.

Nine west London pharmacies sold drugs including Valium, Viagra, temazepam and morphine to BBC1's Inside Out.

Now both the Metropolitan Police and regulator the General Pharmaceutical Council (GPhC) have requested evidence gathered by the programme.

Selling drugs without prescription has a maximum penalty of two years in jail.

An inspector at the Met's Drugs Directorate told the BBC: "It looks like you have evidence of criminality and obviously we need to look at that very closely.

"We would want to look at that as a matter of urgency."

Council contract suspended

The GPhC also requested the evidence. The organisation has the power to remove pharmacists' right to practise in Great Britain.

WHAT THE BBC BOUGHT AND WHERE

Al Farabi, Paddington: Oramorph, Diazepam, Viagra, amoxicillin
Curie Pharmacy, Maida Vale: Temazepam, Diazepam, Viagra, amoxicillin
Bin Seena, Paddington: Valium, Tramadol (offered), amoxicillin
R and C Pharmacy, Willesden: Amoxicillin
Safeer, Paddington: Valium, Viagra, amoxicillin
Craig Thomson, Willesden: Amoxicillin
Al Razi, Paddington: Viagra, amoxicillin

It admitted that prior to the BBC investigation it had only taken one pharmacist in England to a fitness to practise hearing for selling drugs without a prescription in 2012.

Meanwhile a third investigation is being launched jointly by Westminster Council and Inner North West London Primary Care Trust.

Westminster Council has said it is suspending its contract with one of the pharmacies involved.

The council had used Curie Pharmacy in Maida Vale to provide supervised methadone doses to drug addicts.

Undercover reporters were sold temazepam, Diazepam, Viagra and amoxicillin at the business - all without a prescription.

'Extremely disturbing'

Councillor Rachael Robathan, Westminster City Council's Cabinet Member for Adults, said: "The council has suspended its contract with Curie for services, such as controlled consumption by people on recovery programmes.

"We have launched an immediate investigation with Inner North West London Primary Care Trust of these extremely disturbing revelations."

This chemist advised the researcher to take whatever dose of morphine he wanted

Councillor Robathan continued: "The council expect that all pharmacies operate at all times within the law and the regulations governing them.

"The fitness to practise of this pharmacist and others identified will be a matter for our Primary Care Contracts Team."

A Westminster Council spokesman said its officers were also checking training standards were being met at the dozen pharmacies in its area which deliver local authority services.

He added: "This is in direct response to the revelations made by your report."

A spokeswoman for the trust said: "Clearly the accusations are very serious. We will follow our normal procedures and respond to any formal evidence or complaint that is forwarded to us."

“Start Quote

This is the antithesis of what we'd like pharmacists to be doing”

Neal PatelRoyal Pharmaceutical Society

Contacted on Tuesday about the latest developments, all the pharmacies involved declined to comment.

Several London pharmacies sold the reporters from the BBC's Inside Out programme diazepam or its trade name drug Valium - a strong and addictive sedative in the benzodiazepine family - for up to £85.

The BBC was acting on specific intelligence about the pharmacies.

Latest figures show 293 people died in the UK in 2011 from misuse of benzodiazepines, more than double the 125 killed by cocaine and ecstasy combined.

And for £200, Al Farabi Pharmacy in Paddington dispensed a bottle of Oramorph - containing morphine.

A standard NHS prescription would cost about £7.65.

'Shocked and appalled'

Over a few weeks, researchers bought 288 Valium tablets, 21 temazepam tablets, 294 amoxicillin tablets, 24 Viagra tablets and one bottle of Oramorph without prescriptions.

Neal Patel, spokesman for the Royal Pharmaceutical Society, said: "I have been speaking to pharmacists and colleagues are absolutely shocked and appalled at the behaviour we've seen.

"The allegations are the most serious ones I can imagine - pharmacists I know pride themselves on patient safety and this is the antithesis of what we'd like pharmacists to be doing.

"I'm a pharmacist myself and watching this is very difficult for me."

The Labour Party continues to call for a fourth inquiry - into whether the pharmaceutical regulatory system is robust enough.

Shadow Health secretary Andy Burnham said: "The government should review again how pharmacy is regulated. For instance, there is a clear case for unannounced spot-checks to change the regulatory culture."

The Department of Health insists it takes abuse of prescription drugs seriously

Winter bug cases '83% up on 2011'

There have been just over 3,000 lab-confirmed cases.

Latest figures show there has been an increase in cases of norovirus - often known as the winter vomiting bug.

The Health Protection Agency estimates there have been about 880,000 cases in England and Wales since the summer, 83% more than in the same period last year.

But the HPA says these reported cases are the tip of the iceberg and for each one, there will be around 288 that go unreported.

Health Protection Scotland has also reported a rise in cases.

Early increase

The figures also show there were 61 outbreaks of norovirus in hospitals in the fortnight up to December 16 - almost double the number in the same period last year when there were 35.

Norovirus is highly contagious and can be transmitted by contact with an infected person, contaminated surfaces or objects or through consuming contaminated food or water.

It spreads rapidly in closed environments such as hospitals, schools and care homes.

The norovirus "year" - the date from which experts start to count cases - begins in July and runs to the following June.

The increase in norovirus cases is occurring earlier than normal - but experts are unsure why this is happening.

And these figures are a small fraction of the number of confirmed cases seen during the usual peak period of January to March.

However the HPA stresses norovirus is unpredictable, and no two years are the same.

Laboratory confirmed reports represent a small proportion of the actual number of cases because most people do not see a doctor - and therefore their case is not recorded.

'Short-lived'

John Harris, an expert in norovirus at the HPA said: "The number of laboratory confirmed cases has risen again, following the drop in the number we reported last week.

"This is typical of the norovirus season where the number of laboratory reports fluctuates between October and April with the bulk of cases usually occurring between January and March.

"Norovirus is very contagious so we would urge anyone who thinks they may be unwell with norovirus to stay at home and stay away from hospitals and care homes.

"The infection is short-lived although it is very unpleasant while you are unwell.

"Most people will not need to go to see their doctor and will recover in a couple of days. It is important to take plenty of fluids to avoid dehydration."

A Department of Health spokesman said: "The NHS is well prepared for the increase in winter related health problems which are typical at this time of year.

"Our weekly published figures show the number of beds closed across the NHS due to norovirus symptoms is around 2%.

"This compares to 2.9% of beds that were closed during the peak of norovirus cases last winter."

The latest Scottish figures, published on 5 December, showed 2,016 laboratory reports so far this season - up 46% on 2011 figures.

Saturday, 15 December 2012

guilty of killing baby

Grace Adeleye guilty of killing baby in botched circumcision

Grace Adeleye denied causing Goodluck Caubergs' death

A nurse has been found guilty of manslaughter after causing a baby's death by botching his circumcision.

Grace Adeleye, 67, carried out the procedure on four-week-old Goodluck Caubergs at an address in Chadderton, Oldham, in April 2010.

The boy bled to death before he could reach hospital the following day.

Adeleye was found guilty of manslaughter by gross negligence at Manchester Crown Court.

The nurse, who denied the charge, had told the jury she had done "more than 1,000" circumcision operations without incident.

The court heard that Adeleye and Goodluck's parents were from Nigeria, where the circumcision of newborns is the tradition for Christian families.

Adeleye, of Sarnia Court, Salford, was paid £100 to do the operation.

The jury was told that she carried out the procedure using a pair of scissors, forceps and olive oil and without anaesthetic.

She had claimed there had been "no problem" when she left the infant and that his parents had been pleased with the operation.

“Start Quote

Goodluck Caubergs was a healthy little boy whose tragic death was wholly unnecessary”

Jane WraggCrown Prosecution Service

However, the court heard that when Goodluck's parents had changed his nappy several hours later, they had found a large amount of blood and phoned Adeleye, who had told them to redress the wound.

Goodluck's parents called an ambulance the following morning and he was taken to the Royal Oldham Hospital, where he died a short time later.

A spokesman for NHS Oldham said had the family gone to the hospital and asked for a circumcision, "they would have been advised to go to an approved practitioner who would have charged £100, the same as Grace Adeleye".

Following the guilty verdict, Adeleye was bailed while pre-sentencing reports are prepared.

The Crown Prosecution Service's Jane Wragg said the case "was not about the rights or wrongs of circumcision, but the grossly negligent way in which the procedure was undertaken".

"Goodluck Caubergs was a healthy little boy whose tragic death was wholly unnecessary," she said.

"Goodluck died because the standard of care taken by Grace Adeleye in carrying out the circumcision fell far below the standard that should be applied.

"She also failed to inform his parents of the risks and possible complications, which ultimately led to his tragic death."

mengele plus

Tuesday, 25 December 2012

Simple eye scan can reveal extent of Multiple Sclerosis

Simple eye scan can reveal extent of Multiple Sclerosis

Sunday, 23 December 2012

'I have plenty of people to do things with, I just have no one to do nothing with

Lonely Britain