Gardener Dies from Wood Mould

[SteveH]

Gardeners warned over wood mould 
 
Aspergillus mould is very common in UK gardens
Gardeners have been warned about a mould, called Aspergillus, that grows on compost and decaying wood following the death of a middle-aged man.

He developed severe breathing problems after working with rotting wood and plant mulch in his garden.

Medical journal The Lancet reported that the man, aged 47, died despite hospital anti-fungal treatment.

An expert said a dust-mask was a good idea when moving large quantities of mouldy bark chippings or compost.

  This should not be a problem for your average small-scale gardener who is using small quantities of compost at one time

Professor David Denning
University of Manchester

The Aspergillus mould is very common in UK gardens and is better known as an allergy trigger, but serious illness linked to it remains relatively rare.

Lung inflammation

The case of the Buckinghamshire man dates from May 2007, when he arrived at hospital with worsening shortness of breath, a fever and muscle pain.

The results of the X-ray meant that doctors at first thought that pneumonia was the problem and gave him antibiotics.

These had no effect and tests suggested the inflammation in his lungs was getting more severe.

By now he had been transferred to the intensive care unit, but even this made no difference, and he was transferred to a bigger hospital for a last-ditch treatment to get oxygen into his body.

At this point, the laboratory found Aspergillus in two samples and talking to his partner revealed that the day before symptoms started he had been engulfed by clouds of dust while he shifted rotting tree and plant compost.

Unfortunately, although anti-fungal treatments were then given, he died a few days later.

The speed of his decline surprised doctors as, apart from smoking and a job as a welder, he seemed to be in good health.

Alerting doctors

David Denning, of the University of Manchester, said that while Aspergillus itself could be found in many gardens, it would generally be dangerous only if disturbed in large quantities and the resulting dust inhaled.

He said: "This should not be a problem for your average small-scale gardener who is using small quantities of compost at one time.

"However, if you are moving it in very large amounts, then perhaps wearing a face-mask would be advisable."

Prof Denning said that the key to recovery in severe cases was rapid identification of the problem, and prompt anti-fungal therapy, as many doctors would not see any cases of "aspillergosis" in their career, and try antibiotics first.

He said: "This article aims to alert doctors that this may be a possibility when patients present with these symptoms."
 

[SteveH]

Stopping MRSA at the front door 
By Nick Triggle
Health reporter, BBC News 


Ministers have told hospitals to start rolling out MRSA screening over the coming years.

They want to see all patients tested for the superbug to try to curb its spread. But some hospitals are already doing this - with impressive results.

 
Over 25,000 samples are tested each year

Each day hundreds of pods containing nose swabs from patients at London's University College Hospital are placed in a special air-powered tube.

The samples are whizzed under the busy Tottenham Court Road to the hospital's biochemistry labs 800 yards away.

Once there, they are tested for MRSA in what is fast becoming the front-line battleground in the fight against the superbug.

For all the extra funding for cleaning, infection control nurses and hand gels, the best defence against MRSA is to prevent it entering the hospital in the first place.


And that, more or less, is what the hospital is trying to achieve.

Always a chance

Microbiologist Peter Wilson says: "If we can make sure patients do not have the infection on their skin when they come in for treatment, the risk of them getting an MRSA blood infection reduces from 40% to about one in 30.

"There is always the chance that they could get it from the hospital environment or from visitors, but by ensuring they don't have it on them you are giving them every chance."


The hospital, along with the other units in the trust, which includes a specialist heart centre, was one of the first to introduce mass MRSA screening in 2006.


 
 The risk of them getting an MRSA blood infection reduces from 40% to about one in 30

Peter Wilson, microbiologist

Currently, all elective and emergency surgery patients are tested.

And from later this year that will be extended to all in-patients - three years ahead of the government's deadline for the NHS.

The hospital uses a two-hour test, the fastest on the market, developed by Beckton Dickinson.

Elective patients, who include those undergoing operations such as knee and hip replacements, are tested in their pre-op assessments so doctors know the results before they go under the knife.


If the swabs are MRSA positive, the patients are given nose cream and a special wash to eradicate the contamination.

Obviously for emergency patients it is not possible to decontaminate them before they enter the hospital.

But if the results do show they are contaminated with MRSA, doctors then isolate them and give them the special wash and nose cream.


Expense

Of course, the test is not cheap - £17 per test compared to £6 for the old three-day testing system, which was only used sparingly.


But the benefits for patients and the cost of treating them means the screening more than pays for itself.




In 2006, the rate of MRSA infections fell by 39%.

Financially - based on the extra time patients spend in hospital once they have MRSA - this means a saving is in excess of the £400,000 the new testing is costing.

Mr Wilson says: "We don't know if this is all down to the testing as other measures such as cleaning and isolation technique have been introduced. But I would certainly say it is a major factor."
 

[SteveH]

Warnings over body piercing boom 
 
Belly-button piercings are common among young women
Problems over botched body piercings could be a "substantial burden" on the NHS in the near future, a study says.

The British Medical Journal study found one in 10 people - and nearly half of all younger women - had a body piercing other than on the earlobe.

Just over a quarter of people reported complications, including swelling, infection and bleeding.

Many avoided specialist clinics, adding to the risk by piercing themselves or trusting friends or relatives.

Non-specialist piercings could also mean hepatitis infection, experts said.

  There is a message here for the health service, that body piercing is really very common

Dr Angie Bone
Health Protection Agency

Despite the increasing popularity of body piercing in recent years, these are the first firm figures showing the extent of the boom.

The joint study between the Health Protection Agency and the London School of Hygiene and Tropical Medicine asked a sample of more than 10,000 people aged 16 and over in England whether they had been pierced somewhere other than the earlobe, and if they had suffered any complications as a result.

They found approximately 10% had some sort of body piercing, with women and younger people most likely to have one.

Half of those who had experienced complications said the problems were bad enough to seek further help, and a small number required hospitalisation.

Four out of five piercings were carried out at specialist shops, which are licensed and inspected by the local authority, and complications were less likely.

A small number of those surveyed, however, admitted that they had carried out piercings of the tongue, lips and genitals without official expert help - 9% of tongue piercings were carried out this way.

10 months to heal

Dr Angie Bone, one of the research authors, said she had been surprised by the finding that 46% of 16-to-24-year-old girls had a body piercing, and said that if this generation, and following generations, continued this way, it might be a problem for the NHS.

She said: "There is a message here for the health service that body piercing is really very common and, if it remains fashionable, in the near future one in two women will have a body piercing and there will be more complications."

Dr Bone said many people were unaware of the potentially serious nature of a piercing and stressed the importance of using a specialist clinic.

"I was surprised to find, for example, that a navel piercing can take up to 10 months to heal."

Another potential risk from piercings, especially those carried out abroad or away from regulated clinics, comes from blood-borne viruses.

A spokesman for the British Liver Trust, which offers advice on avoiding hepatitis infection, said: "It is important to remember the long-term problems that can occur, particularly if you get a piercing from a non-specialist.

"You put yourself at a high risk of contracting hepatitis B or C, both of which are serious, life-threatening conditions which can be fatal.

"You may not know you have contracted the virus until later on in life when the damage has already begun."
 

[SteveH]

Abortion increase in young girls 

Anne Quesney from Marie Stopes International on the rise
The number of abortions among girls aged under 16 rose by 10% to 4,376 in 2007, official figures for England and Wales show.

In the under 14s, abortions rose by 21% from 135 in 2006 to 163 last year.

The number of abortions in all women rose by 2.5% to reach an all time high of almost 200,000.

Government advisers called for high quality sex education at school and investment in contraception services for young people.

Scotland has also seen a rise in the number of abortions with figures published in May showing there were 13,703 carried out in 2007 compared with 13,163 in 2006.

The number of abortions carried out has been rising ever since the 1967 Abortion Act - with just over 22,000 terminations in the first year.

In the past decade, the number of abortions in the under 16s has risen by 27%.

But at the same time the teenage pregnancy rate has fallen.

Early-stage

Some 90% of abortions were carried out at under 13 weeks' gestation and 70% were at under 10 weeks, a slight increase on last year's figures.

  We need high quality sex and relationships education at school and at home and effective contraception

Gill Frances, Teenage Pregnancy Independent Advisory Group

A total of 198,499 abortions were carried out in 2007.

The number of terminations carried out using the "abortion pill" was 35% up from 30% in 2006.

Around 1% of abortions were carried out on the grounds that the child would be born disabled.

Gill Frances, chair of the Teenage Pregnancy Independent Advisory Group, said: "We know what works to reduce abortion amongst teenagers.

"We need high quality sex and relationships education at school and at home and effective contraception.

"Primary Care Trusts must ensure they are investing in contraceptive services for young people."

She added that PCTs had been given £13m to improve contraceptive services but because the money had not been ring-fenced there was a danger it would be spent on other services.


 


Health Minister Dawn Primarolo said the figures showed considerable progress in reducing waiting times for abortion, with two-thirds of women now having a termination at under 10 weeks.

She added: "Contraception plays a vital role in preventing teenage pregnancy and earlier this year I announced a further investment of £26.8m to improve women's access to contraception and help reduce the number of abortions, repeat abortions and teenage pregnancies."

Precautions

Claire Curtis Thomas MP, a member of the All-Party Parliamentary Pro-Life Group said: "These figures show that far from further liberalising the law as some MPs want to do, there is a real need to tighten it up, to show a greater regard for the unborn child.

"The numbers of UK abortions are truly horrifying.

"We should be putting all our effort into reducing these numbers through sensible precautions such as offering a full range of information to women considering abortion."

Ann Furedi, chief executive of the British Pregnancy Advisory Service, said: "Much more needs to be done to equip young people to deal with the complexities of their personal relationships and to empower them to ask for high quality, user-friendly forms of contraception without embarrassment.

Julie Bentley, chief executive at the FPA (Family Planning Association) said sex and relationship education should be compulsory in every school.

"Younger women are making different choices about their lives and choosing abortion over motherhood, but education and contraceptive services will stop them becoming pregnant in the first place."
 

[SteveH]

Concerns over foreign transplants 
 
The hospital said it complied fully with transplant guidelines
A London hospital has been referred to health watchdogs after concerns that too many liver transplants are being given to foreign patients.

The Healthcare Commission was alerted after 72 non-British EU nationals were given new livers in four years at King's College Hospital.

Of those, 37 were given to Greek and Cypriot nationals in what were classed as "private" operations.

But the hospital said non-UK patients could not "buy" a transplant.

It said the figures were an anomaly caused because the Greek and Cypriot governments operate a different funding arrangement with the Department of Health than other states.

Most countries pay the Government a block fee to cover their citizens' treatment in the UK. However, Greece and Cyprus pay hospitals directly on a patient-by-patient basis and so the procedures are classed as "private".

NHS guidance

The proportion of Greeks and Cypriots was so high because unlike most European countries, they do not operate their own transplant system, the hospital added.

In a statement, King's College Hospital, Europe's leading liver transplant centre, said it carried out 210 liver transplants in the year to this April, including 24 on patients from other EU countries. Eighteen of them were from Greece and Cyprus.

  Decisions over... allocating an available liver rests with the individual transplant centre

Department of Health spokesman

It said: "King's carries out liver transplant surgery on non-UK EU patients, as it is required to do so in accordance with NHS guidance and European Law.

"In accordance with current NHS guidelines for transplantation and European law, all EU patients awaiting liver transplant surgery at King's are assessed and prioritised according to clinical need only.

"There is absolutely no truth in the assertion that patients from outside the UK can 'buy' a transplant at King's."

European law dictates that EU citizens are equally entitled to NHS services, including transplants, as Britons. However, some hospitals choose to prioritise UK patients.

Board members of NHS Blood and Transplant (NHSBT) made the decision to refer the situation to watchdogs.

In a statement it said: "The Board was presented with information about the unusually high number of non-UK EU residents who received liver transplants at King's College Hospital NHS Foundation Trust between 2003-2007.

'Equal access'

"While there is no evidence that the organ allocation system is being breached, NHSBT has an overarching statutory responsibility to ensure the integrity of organ donation."

There are currently 285 patients awaiting a new liver in the UK. Organs are allocated depending on their size, blood group and severity of their condition. However, emergency cases always receive priority.

A Department of Health spokesperson said: "The transplantation of donated livers into non UK EU residents who qualify for NHS treatment is lawful. This is guided by European law which effectively regards such patients as having equal access to the NHS.

"Decisions over accepting a patient onto the transplant waiting list and allocating an available liver rests with the individual transplant centre."

 

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