Tag Archives: biological therapy

Hospitalizations for Food Anaphylaxis Threefold, But Deaths Decreased | Instant News


UK hospital admission rates for food-induced anaphylaxis more than tripled over the 20 years from 1998 to 2018, but the case fatality rate fell by more than half, the researchers report in BMJ.

“Cow’s milk is increasingly being identified as an allergen to fatal food reactions, and is now the most common cause of fatal anaphylaxis in children,” writes Alessia Baseggio Conrado, PhD, a biochemist from the National Heart and Lung Institute at Imperial College London, United States. Kingdom, and colleagues. “Further education is needed to highlight the specific risks that cow’s milk poses to allergic people to raise awareness among the food business.”

While recognition of the risks posed by peanut allergies has increased, people think dairy allergies are mild, says senior author Paul. J. Turner, BM BCh, PhD, allergist / immunologist at Imperial College. “This often occurs in very young children, but school-age children who still have a milk allergy tend to have a larger allergy profile, often with other allergies, including asthma, “Said Turner Medscape Medical News. “Additionally, milk is very common in our diet, and you don’t need a lot of milk to reach a decent dose of allergens.”

During the study period, 101,891 people were hospitalized for anaphylaxis; 30,700 cases (30%) were coded as being triggered by food.

This food-related income showed an increase from 1.23 to 4.04 per 100,000 population per year, with an annual increase of 5.7% (95% CI, 5.5 – 5.9; P. <0.001), write the authors.

The greatest jump was among children under 15, whose enrollment increased from 2.1 to 9.2 per 100,000 population per year, an annual increase of 6.6% (95% CI, 6.3 – 7.0) . The annual increase was 5.9% (95% CI, 5.6 – 6.2) among people aged 15 to 59 years and 2.1% (95% CI, 1.8 – 3.1) among people those aged 60 years and over.

Researchers used data from England, Scotland, Wales, and Northern Ireland to track temporal trends and age and sex distribution for admissions to hospital admissions whose primary diagnosis was anaphylaxis due to food and non-food triggers. These data are compared with nationally reported deaths.

Over a 20 year period, 152 deaths were associated with possible food-induced anaphylaxis. During that time, the case fatality rate for confirmed fatal food anaphylaxis fell from 0.7% to 0.19% (rate ratio, 0.931; 95% CI, 0.904 – 0.959; P. <0.001) and fell to 0.30% for suspected fatal food anaphylaxis (rate ratio, 0.970; 95% CI, 945 - 0.996; P. = 0.024).

Between 1992 and 2018, at least 46% of all anaphylactic deaths were thought to be triggered by peanuts or tree nuts. Among school-aged children, 26% of deaths from anaphylaxis are caused by cow’s milk.

Not surprisingly, during the study period, there was a 336% increase in prescriptions for adrenaline autoinjectors. Such prescriptions increase by 11% per year.

Global Trends

The data extends the findings of Turner and colleagues reported for England and Wales in 2014 about the entire population of England and in line with epidemiological trends in hospital admissions for anaphylaxis in the United States and Australia.

The investigators say better recognition and management of anaphylaxis could partially explain the reduction in mortality, but the increase in hospitalizations remains confusing. “Whether an actual increase in the prevalence of anaphylaxis has occurred (rather than a decrease in the threshold for admitting patients with anaphylaxis) is unclear due to a lack of evidence for an increase in the prevalence of food allergy in the UK (and elsewhere) over the same time period,” they wrote.

Ronna L. Campbell, MD, PhD, an emergency doctor at the Mayo Clinic in Rochester, Minnesota, has noted a similar trend in the United States. “Perhaps the introduction and diagnosis of anaphylaxis has increased, so the drug administration is earlier epinephrine, “Said Campbell Medscape Medical News. “So, as cases increased, earlier recognition and treatment resulted in reduced mortality.” He is not aware of any new guidelines recommending increased hospitalizations that would explain the confusing increase in admissions.

According to the study authors, the clinical criteria used to diagnose anaphylaxis in the UK did not change during the study period. Although national guidelines recommend that hospitalization of children under 16 years of age suspected of having anaphylaxis were introduced in 2011 and may have increased patient admissions, the year-over-year rate of increase has persisted since 2014. “Therefore the increase over the past five years cannot associated with the impact of the guide, “they wrote.

The study was funded by grants from the UK Medical Research Council and the UK Food Standards Agency. Two co-authors have disclosed financial links to industry outside of the jobs that are sent. Conrado did not disclose the relevant financial relationships.

BMJ. Published online February 17, 2021. Full text

Diana Swift is a medical journalist based in Toronto.

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Age 40+ With Diabetes Should Be a Priority for the COVID-19 Vaccine | Instant News


People with type 2 diabetes as young as 40 face a disproportionately increased risk of dying from COVID-19 infection, suggesting a British analysis of three large-scale data sets highlighting the need to prioritize vaccination in younger groups of vulnerable patients.

Research it published February 8 in the journal Diabetology.

Most European countries have prioritized COVID-19 vaccination for people with type 2 diabetes, but usually only age 50 and over. However, data from the current study suggest that this age limit should be lowered.

“It is important to remember that the risk of dying from COVID-19 in middle-aged people with diabetes is very low in absolute terms compared to the elderly,” said lead researcher Andrew P. McGovern, MD, of Royal Devon & Exeter Hospital, Exeter. , United Kingdom, in a press release from its agency.

However, he said that “strategies for determining priority groups for vaccination must take into account the disproportionate relative risk of COVID-19 death in middle-aged people with type 2 diabetes whose risk of COVID-19 has already increased with their age.”

McGovern informed Medscape Medical News that the magnitude of the effect of type 2 diabetes on deaths from COVID-19 is “absolutely shocking” about the new findings, and “not what you expected.”

Therefore, he said it was imperative that diabetics be put “in line” to get the vaccine “in the right place, and clearly in countries where vaccine rollout will be slower, it is more important.”

Bridget Turner, director of policy and improvement campaigns at Diabetes UK, which funded the study, said the results provide “important new insights into how much type 2 diabetes adds to the overall risk of dying from coronavirus at different ages, particularly the additional risk of that condition. increases in middle age. “

“The UK has made good progress in prioritizing those most vulnerable for vaccination, which includes all adults with diabetes,” he added in a press release, “but we need to continue to work with pace to identify and protect those people at a greater level. high risk. “

The Relationship Between COVID-19 Death and Diabetes Is Complex

The authors note that the association between COVID-19-related death and type 2 diabetes is not only a “co-effect of diabetes and age-related risk” but appears to be a “more complex” relationship, with “a disproportionately higher relative risk of excess relative risk.” death in young people with diabetes. “

To investigate this, they examined data from two UK population-based studies that previously reported age-specific hazard ratios for diabetes-related COVID-19 deaths:

  • Open safely, which includes 17.2 million people, 8.8% of whom have diabetes, and has an overall 90-day mortality rate of 0.06%.

  • QCOVID, comprising 6 million people, of whom 7% had diabetes, and had an overall 97-day mortality rate of 0.07%.

The team also looked at data from type 2 diabetes patients with severe COVID-19 from the COVID-19 Hospitalization in England Surveillance System (CHESS), which contained 19,256 patients were admitted to critical care in the UK, 18.3% of whom had diabetes.

The 30-day hospital mortality rate in this study was 26.4%.

They translated the death hazard ratio associated with COVID-19 infection in diabetics to “COVID-19 age,” which equates to additional years of “risk of death” added to the individual’s chronological age if diabetes is present.

Taking the QCOVID dataset as an example, the results showed that the diabetes-related “COVID age” for someone aged 40 was 20.4 years; which would indicate that “the risk of death [for COVID-19] similar to a 60 year old without diabetes. “

The impact of diabetes on the risk of death from COVID-19 decreases with age, so that diabetic patients aged 50 have COVID-19 aged 16.4 years. This drops to 12.1 years in someone who is 60, and 8.1 years in someone who is 70, meaning the latter has the same risk of dying from COVID-19 as someone without diabetes who is 78 years old.

Similar results were obtained when the team looked at data from the OpenSAFELY study.

But when they looked at the effect of diabetes on the risk of dying from COVID-19 in the CHESS data set, it was less visible..

Just Looking At Diabetes Is Too Simple, But It’s An Easy Marker For Vaccination

The investigators acknowledge that “only considering age and diabetes status when assessing COVID-19-related risk … is an oversimplification,” because factors such as body mass index (BMI), diabetes duration, and glycemic control are also known to play an important role. authority.

However, they said consideration of these factors was “impractical for vaccine rollout at the population level.”

“The time-critical nature of the COVID-19 vaccination population requires pragmatic group level priority, which is the approach initiated by the government so far,” the team concluded.

This study was supported by Diabetes UK. Study author John M. Dennis was supported by an Independent Fellowship funded by the Research England’s Expanding Excellence in England (E3) fund and by the NIHR Exeter Clinical Research Facility. McGovern is supported by the NIHR Exeter Clinical Research Facility.

Diabetology. Published online February 8, 2021. Full text

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Advanced Prostate Cancer Still Rises in the US | Instant News


The incidence of advanced prostate cancer in the United States “continues” to increase every year for 5 years after the United States Prevention Service Task Force (USPSTF) controversially suggested in 2012 opposes prostate specific antigen (PSA) screening in men of all ages, new research shows.

But a biostatistics expert not involved in the study said the USPSTF recommendations were not entirely to blame because “you need 5 to 7 years of minimum time lag to influence PSA screening,” and suggested that other factors come into play.

In the new study, Ahmedin Jemal, DVM, PhD, from the American Cancer Society and colleagues reported that for the 2012-2016 period there was a statistically significant increase every year in the incidence of regional stage disease (with an absolute 11% per year) and in distant stage disease ( absolute 5% per year).

At the same time, there is an annual decrease in the incidence of local prostate cancer in men 50 years or more.

The new study is the first to report data until the end of 2016.

Two trends – an increase in advanced cancer and a decrease in early cancer – have been occurring for 10 years, more or less, but with a steady and sharp increase in advanced disease from 2010 to 2012, the findings show.

“This data illustrates the trade-off between higher screening rates and more early diagnosis of disease (possible overdiagnosis and overtreatment) and lower screening rates and more (possibly fatal) end-stage disease,” comment the authors.

That research published online today at Journal of the National Cancer Institute.

Several previous studies have reported changes in the pattern of events following the USPSTF recommendations on PSA screening for men aged 75 or over in 2008 and all men in 2012, but the data is not later than 2015.

“We have seen clues about this change in recent years and now we have further confirmation,” said Ahmad Shabsigh, MD, urological oncologist at Ohio State University Comprehensive Cancer Center, who were asked for independent comments.

“What is surprising is that every year,” Shabsigh said Medscape Medical NewsRefers to an increased incidence of advanced cancer.

“Seeing it clearly in this study is sad,” Shabsigh added.

The study period began in 2005, but did not cover the years after 2018, when the USPSTF recommendations changed again and suggested that “individual” screening for men 55-69, and that men aged 70 years and over should be issued.

US cancer registration data, which are the source of current research, are not yet available to assess the impact of this latest change.

End with Vision?

There has been a decline in the proportion of men who underwent PSA testing in the US in recent years, the study’s authors point out.

The rate of routine PSA testing among men aged 50 and older decreased from 40.6% in 2008 to 38.3% in 2010, and fell to 31.5% in 2013, a percentage held again in 2015, per survey data reported nationally alone.

The study authors say that the cause of the increase in advanced cancer is uncertain because of the descriptive nature of their study.

But Andrew Vickers, PhD, a biostatistician at the Sloan Kettering Cancer Center Memorial in New York City, said the rise in advanced cancer and the decline in early stage cancer reported in this study was “suggestive of a causal relationship” and “screening”. effect.”

Vickers argues that there are “a number of trends that appear together at the end [2000s] influence [PSA] filtering.”

For example, two randomized clinical trials for PSA screening first reported “unfavorable” results in 2009, which were during the period covered by this study, and reduced enthusiasm for screening.

European Random Screening Study for Prostate cancer (ERSPC) and US-based Prostate, Lung, Colorectal and Ovarian (AS) Cancer Screening Tests reported little or no effect on mortality, the main results of the trial.

It would surprise me if we had reached the lowest point …
Andrew Vickers, PhD, biostatistician at MSKCC

Medscape Medical News asking Vickers to speculate about how long the incidence of advanced prostate cancer will continue to increase in the United States.

“It will surprise me if we make it to the lowest point [and reached peak increases in advanced cancers] or if we have more time to go, “he said.” My prediction is that if nothing has changed we might see some further improvement in [the incidence of] advanced disease. “

What needs to change? Vickers marks the list of “golden rules”.

  • First, doctors need to get approval for all PSA tests.

  • Second, PSA tests should not be given to older men “who will not benefit,” such as men 75 years and older with comorbidities such as heart disease.

  • Third, PSA testing must be restricted to younger men.

  • Fourth, doctors need to be more restrictive about biopsies. “In the past if you had a high PSA, you would get a biopsy,” he said, adding that this approach produced many invasive tests in men with low-grade disease. By using additional tests such as 4Kscore or Prostate Health Index or MRI, doctors can limit biopsies in men with a higher chance of developing high-level cancer. Vickers admitted there was a conflict of interest at this point, because he was the patent holder of 4Kscore.

  • Fifth, do not treat men who are highly unlikely to benefit, especially men with Gleason grade 6 disease. Use active supervision for these people, he said. “By using our existing knowledge, I believe we can truly change the hazard-to-benefit ratio from PSA screening. We will drastically reduce overdiagnosis and overtreatment,” he said.

In addition, Vickers believes that urologists need to educate local internists and general practitioners and recognize that screening and subsequent treatment “are done wrong for a long time.” At the same time, urologists must explain that patients will not be biopsied “unless there is very good reason to believe that they have a high risk of high-level disease.”

Vickers concluded: “We can reduce the danger and maintain the benefits of screening.”

This research was supported by the American Cancer Society. Jemal and Shabsigh do not disclose relevant financial relationships. Vickers states that he is the patent holder of 4Kscore.

Journal of the National Cancer Institute. Published online May 20, 2020. Abstract

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Why is the UK so much better on the Molecular Profile? | Instant News


Molecular testing is an invaluable resource in lung cancer, but the latest evidence shows that many US practitioners do not use it. Real world data in patients with stage IIIB or IV non-small cell lung cancer (NSCLC) found that only 54% were tested for epidermal growth factor receptor (EGFR) and 22% for anaplastic lymphoma kinase (ALK), ROS-1, and BRAF. Even when testing is done, it may not be enough to inform treatment decisions. A 2019 study at JAMA reported that only two thirds of patients with EGFR mutation or ALK rearrangements never receive an appropriate inhibitor during the course of their disease.

In comparison, Britain seems to have a lot to be proud of when it comes to molecular testing. Recently reported data from the United Kingdom National Lung Cancer Audit revealed that 83% of patients with advanced adenocarcinoma underwent testing EGFR, ALK, ROS-1, and programmed death ligand 1 (PD-L1). However, audit findings at the level of patients receiving appropriate targeted care and average survival indicate that the UK also has room to improve.

To find out what caused the differences in the UK and US approaches, Medscape contributor Dr. Jack West spoke with Dr. Sanjay Popat, professor of chest oncology at The Institute of Cancer Research and consultant in medical oncology at Royal Marsden Hospital in London, United Kingdom.

H. Jack West, MD: Let’s discuss what works and what hurts in both of our systems, because that is an important step to fix it.

Sanjay Popat, MD: In Britain, some things are a little better, some are similar to problems in the United States, and some are a little worse.

What we do very well is the penetration that testing has in the population. That’s clear in the 83% testing rate for biomarkers funded by the National Health Service (NHS). The data is for every patient who walks through the doors of a number of centers in 2017.

But when you look a little deeper, you see the problem. Of those identified EGFR positive mutants, only 75% received EGFR tyrosine kinase (TKI) inhibitors upfront. Even worse, only 58% ALKPositive patients receive ALK inhibitors. I feel this is very sad because this is the most effective medicine we have.

There must be a reason why this genotype was not translated into TKI recipes. Do cancer experts really take the results and find out the next step based on this limited amount of biomarkers? In general, I think they did, because to prescribe immunotherapy in the UK, you have to prove on the form that patients are the wild type to EGFR and ALK.

One possible cause is the turnaround time, which we have a problem with. Or maybe more complex.

West: Completion time is certainly a major challenge in the United States, where it routinely takes 3 weeks or more to complete network-based testing. Many patients want to be treated very quickly.

If molecular testing will take 3 to 4 weeks or more, even cancer experts who have a preference for it might feel that they might not be wrong in giving chemotherapy and immunotherapy. Or say you get the PD-L1 returned very quickly and then have to wait for molecular testing; it is very tempting to act at high PD-L1 levels and maybe just starting a single agent pembrolizumab.

Then there is a sense of competition in the United States. Patients who are not inclined to wait can leave your place of practice for an oncologist at the end of the road who will start treating them quickly. Many of my colleagues have expressed concern about having to convince patients that it is better to wait for the test results than to start treatment now, just to get things going.

Popat: We do not have the same commercial pressures that desperately need to start some form of systemic therapy, although it may not be clinically indicated. Patients have no hope of going to other practices, which may not have availability even if they do.

There are some cultural differences too. The NHS system does not allow you to prescribe pembrolizumab unless you really confirm that the patient is a wild type EGFR and ALK. That is the same thing for chemotherapy plus immunotherapy. You can prescribe it, but you have to prove that the patient is a wild type.

Another thing to consider is that in many centers, if you decide you want to provide some kind of systemic therapy, the patient may wait 2 weeks (if not longer) for the first cycle. That allows a little time buffer so that molecular results can appear.

Biopsy on Both Sides of the Atlantic

West: About 1 in 10 patients in the National Lung Cancer Audit report has insufficient tissue. In the United States, these patients can start chemotherapy plus temporary immunotherapy. It does not seem like a real possibility in the UK, because basically you are required to do whatever needs to be done to get molecular data. What is the impact of retesting?

Popat: Retest rate in UK audits is around 10% because initial specimens are inadequate. However, that possibility is too low. I suspect that many people who start chemo, with or without immunotherapy, are in situations where we do not have enough specimens to understand their true genotype. These patients may be biopsied at some stage in the future, which is also a challenge to do after they start receiving chemotherapy.

We really want to move towards liquid biopsy. I would love to be in a position where we have the next generation of DNA sequencing (ctDNA NGS) circulation in advance. Unfortunately, Britain lags behind this, given the large costs associated with NGS ctDNA. Several commercial providers have signed schemes with each institution to allow this approach for the selection of biomarker patients for trial registration, but certainly not close to standards.

West: Liquid biopsy is available in the United States, but is not consistently used and replaced.

Another problem that we sometimes face here is that genetic testing reports can be uploaded to random media tabs from challenging and expansive electronic medical records, never seen by the human eye. How likely is it in the UK system?

Popat: In general, our system works very well in this regard. Stopping hard is basically not prescribing chemotherapy plus immunotherapy or immunotherapy alone unless you know what you are seeing. It really forces these results to be seen and verified.

Most pathology and molecular diagnostic tests occur in established tissues with oncologists, so the results get feedback from both oncologists and clinical nurse specialists. Nurse specialists have a role in instigating molecular testing, ensuring results have reached the laboratory and returned, and marking one of the positive results to the oncologist. This means there is a much smaller chance of results just drifting off to random pages in electronic medical records.

Room for Improvement in Both Systems

West: Success reported in the National Lung Cancer Audit is accompanied by quite serious results. The average survival for the wider population is only 7 months, and only 1 year for those who have EGFR mutation. That’s a lot less than I expected to see a population enriched with a targeted therapy. What do you think contributed to that?

Popat: I fully agree and, to be honest, feel very shameful. I think you must remember, however, that this is the whole population. This is not only suitable for patients you normally consider enrolling in trials, but also for those diagnosed as emergencies, sick, or unhealthy. You see the entire population, not just a crème de la crème part

Because of this, the result data is far worse than we expected. I think that can be partly explained by many things.

For example, we still provide first generation inhibitors on EGFR settings and must hunt for testing T790M before giving osimertinib. T790M testing has a problem. I am not sure that we often actually follow up on a negative T790M test with an appropriate biopsy, as the patient slowly develops.

I am also worried that the patients themselves are not interested in undergoing additional biopsies. There is always a fear of having chemotherapy, even though we know it is a very effective rescue treatment for the T790M-negative population. I want to know more about the patient’s perspective here.

There is a lot of work to be done to optimally manage oncogenic addiction. We don’t do very well oncogen oligoprogress here, because stereotactic body radiotherapy is not routinely funded. These patients must undergo trials. Radioturgic stereotactic provisions for patients with central nervous system (CNS) development vary greatly. CNS monitoring in patients with oncogenic addiction is still poor.

This all contributes to suboptimal results. We really need to realize that patients can do very well if treated aggressively, and obtaining a TKI is an absolutely essential part of this. And, clearly, acknowledging that this is a patient who is addicted to oncogenes is initially the key.

West: The message that was brought home to me was that there was clearly remarkable new progress in our care and understanding of how cancers adapted to them. It takes a lot of effort to apply that knowledge and educate the wider community to realize this promise. Even with some of the successes reported in the United Kingdom, none of us has broken this code into a great system of work.

H. Jack West, MD, associate clinical professor and executive director of employer services at the City of Hope Comprehensive Cancer Center in Duarte, California, regularly comments on lung cancer for Medscape. West serves as a web editor for JAMA ONCOLOGY, edit and write several sections about lung cancer for UpToDate, and leads a variety of continuing education programs and other educational programs, including hosting audio podcasts West wind.

Sanjay Popat, PhD, FRCP, is a professor of thoracic oncology at The Institute of Cancer Research and a consultant in medical oncology at the Royal Marsden Hospital in London, England. His research interests include identifying DNA variants that influence the development of thoracic tumors, identifying biomarkers that can predict therapeutic effects, and developing new strategies for treating thoracic tumors through clinical trials.

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Deaths Exceeds 26,000 in New Methodology | Instant News




This is a British coronavirus story that you need to know about today.

Deaths Exceeds 26,000 in New Methodology

The new total for UK COVID-19 deaths is 26,097 – the first number based on new reporting methods. That means Britain has the second highest number of COVID-19 victims in Europe after Italy.

Public Health England (PHE) said the increase was due to today’s figures being revised retrospectively to include additional data sources.

An additional 3811 deaths were added to the total. Of these, PHE said, around 70% were outside hospitals (including nursing homes) and around 30% were in hospitals. Additional hospital deaths were identified through the PHE laboratory system.

There were 765 deaths in British hospitals reported today.

Dr Yvonne Doyle, Medical Director at PHE, said in a news release: “Tracking the number of deaths every day is very important to help us understand the effects of this disease.

“This more complete data will give us a more complete and more current picture of death in the UK and will inform the government’s approach as we continue to protect the public.”

Of the 445 deaths in British hospitals patients aged between 14 and 101. Of these, 27 aged between 14 and 94 had no known basic health condition.

Data from the National Records of Scotland released today show that 338 of the 656 deaths recorded between 20 and 26 April were in the nursing home. Overall, 39% of COVID-19 deaths registered in Scotland were related to deaths in nursing homes, 52% of deaths in hospital, and 9% of deaths were at home or in non-institutional settings.



Case Data

Prof. Doyle told Downing Street briefing about the latest case data.

In new cases. “The case has remained broadly stable over the past few weeks, and that is good news.”

About hospital beds: “This is good news because the number in hospitals has dropped from more than 18,000 to more than 15,000, that’s a 16% decline.”

About the use of critical care beds: “This is good news because we can see here that 40% of beds are being used. That means there is a critical care capacity.”

With one day left to meet the government’s 100,000 COVID-19 test target every day, 52,429 tests were carried out yesterday. Capacity is now more than 73,000 per day.

NHS Deaths

Among the deaths of NHS workers recently announced were three nurses:

  • Fiona Anderson is a community staff nurse at Grindon Lane Primary Care Center, Sunderland. His family statement said he died “doing what he loved, working for the NHS and caring for those in need”.

  • Jodon Gait, 46, works in a medical inpatient unit at the Royal Hospital in Worcestershire. Tributes said he was “a dedicated, passionate, caring colleague”.

  • Larni Zuniga, 54, is a nursing home nurse in Godalming, Surrey. Friends say he moved to England to try to make a better life for his family.

In Memoriam: Health Workers Who Died Due to COVID-19.

Other News Short

  • Cancer deaths in people newly diagnosed in the UK can increase by at least 20% over the next 12 months, according to a precast study by UCL / DATA-CAN. Senior author Professor Harry Hemingway, Director, UCL Institute of Health Informatics, said in a news release: “The overall impact of an emergency COVID-19 on death in cancer patients can be enormous. There are many factors operating here including rapid changes to diagnosis and treatment protocols, social distance measures, changes in people’s behavior seeking medical attention and the economic impact of COVID -19, as well as deaths due to COVID-19 infections. “

  • The NHS UK urges people suspected of having cancer symptoms to seek medical advice. The move comes after a survey by Portland showed that 1 in 10 people will not contact their doctor with a new lump or mole that does not disappear after a week. Professor Peter Johnson, national clinical director for NHS cancer, said in a news release: “NHS staff have made great efforts to deal with the corona virus but they are also working hard to ensure that patients can safely access important services such as cancer screening and urgent surgery. “

  • Rapid COVID-19 clinical trials are being launched under ACCORD UK (Acceleration of the COVID-19 Research & Development platform). The UK’s Chief Research and Innovation Professor Professor Sir Mark Walport said in a news release: “Bringing together expertise from a variety of world-class UK research and innovation sectors – from clinical researchers to the pharmaceutical industry – this national platform will quickly prioritize and provide the best potential drugs in clinical trials to find out if they can help people with COVID-19. “

  • More health workers from outside the UK and their families are getting visa extension free. This includes midwives, radiographers, social workers, and pharmacists. This follows a similar announcement last month for doctors, nurses and paramedics. Family members and dependents of health workers who died after testing positive for COVID-19 will also be offered unlimited leave to remain in the UK.

  • Don’t wash NHS uniforms at home to reduce the risk of COVID-19 transmission, say experts from De Montfort University, Leicester. Dr Katie Laird, reader in microbiology and head of the infectious disease research group, has written a letter to the ministers to raise concerns about UK Public Health guidelines which say if industrial or hospital laundering is not available, health workers must bring their uniforms to the house in disposables plastic bags. Dr Laird said deeply news release: “By bringing their uniforms home, workers risk contaminating their home environment, including washing machines,” he added: “If the virus is in the uniform, it can move to other surfaces or clothing items in washing.”

  • Treatment rules have relaxed for nursing homes so that, if clinically appropriate, drugs labeled for use by one patient can be used by another patient. At present if the patient no longer needs it, or has died, the drug is destroyed. Medicines must be checked by a registered health professional to ensure that they are suitable for reuse.

  • When schools reopen in the UK there will be a gradual approach, Education Secretary Gavin Williamson told the Select Education Committee. “All schools returning on the first day with complete students will not be realistic,” he said. Professor Jonathan Van-Tam, representative of the British CMO, was asked how social distance would work at school: “I think it will be very difficult with classrooms of 4-year-old children, 5-year-old children, I think it will be very complicated. I think we should think about all those actions and how they can work. ”

See more global coronavirus updates at the Medscape Coronavirus Resource Center.

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