HomeFocus

Focus

When common sense and sound judgment go up in smoke

Government’s proposed anti-tobacco bill lacks any scientific assessment as an underlying principle of legislation, argues Tim Cohen, senior editor of Business Day. In a...

Troublesome issues in e-cigarette policy in America

The Tobacco Harm Reduction (THR) and e-cigarette policy scene continues to evolve in a direction that will result in substantially more tobacco-related addiction, illness...

Reimagining addiction

Ill-informed opinion, rather than evidence, and an often misguided sense of what is moral shape attitudes to addiction and its treatment. In this fake...

Public Health England: Stopping smoking – What works?

Public Health England recently published Health Matters guidance focusing on the range of smoking quitting routes that are available and the evidence for their...

US FDA warns companies of ‘illegal’ e-cigarettes in crackdown on youth vaping

On 12 October the US Food and Drug Administration said it had sent letters to 21 e-cigarette companies questioning the legality of 41 of...

Workplace and Recovery – How US employers and employees handle addiction

Nearly three-quarters of US employers feel guilty about how they have handled employees’ drug or alcohol addiction-related problems, according to a survey of 737...

Expert opinion divided over health impacts as SA legalises dagga

Following the legalisation of cannabis for personal use in South Africa, the SA Society of Psychiatrists and the SA Medical Association warned of its...

WHO launches new strategy to accelerate global tobacco control

The Conference of the Parties to the WHO Framework Convention for Tobacco Control closed its eighth session – COP8 – on 7 October after adopting...

‘White paper’ call to action on vapour products, harm reduction and taxation

The International Center for Law & Economics in the US has produced a white paper it describes as a call to action for economists and health...

Cigarette market is soaring in Africa – UCT study

Tobacco companies are thriving in Africa due to weak anti-tobacco and tax laws. A study by the University of Cape Town’s Economics of Tobacco Control Project found...

Supporters of South Africa’s Tobacco Bill speak out

Following a cacophony of criticism of South Africa’s Tobacco Bill, supporters the legislation are having their say. An article in Daily Maverick outlines a...

Urgent strategies needed to tackle US opioid crisis – Doctors have a role

There are many ways to tackle America’s growing opioid addiction crisis. In articles in USA Today, a behavioural economist and a chief medical examiner...

Fiery responses to SA’s draconian Tobacco Bill

SA’s Tobacco Bill has met with a barrage of criticism, among other things for proposing jail for smoking in public, outlawing designated smoking areas,...

International experts highlight ‘significant weakness’ in SA Tobacco Bill

In a last-minute submission on the SA Tobacco Bill, international academics argue that the Bill does not sufficiently differentiate between nicotine products of widely...

‘This should change everything’ – A performance standard for cigarettes

Unlike many other consumer products, no safety standards have been set for cigarettes or other tobacco products. Now a performance standard proposal has been...

Advancing tobacco regulation for public health – New FDA initiatives

Over the past year, the US Food and Drug Administration has taken important steps towards achieving its overarching goal – a world where cigarettes...

Negligence killing new-borns; PSC grilled on 'sanitised' report

More than 80,000 newborn babies died within just two years as a result of negligence and the poor quality of healthcare in public hospitals, according the Saving Babies report of the SA Medical Research Council. Meanwhile MPs challenged the Public Service Commission (PSC) on its ’sanitised' findings about the state of public health services, suggesting that patients faced a far bleaker picture than that painted.

Physical activity slashes mortality risk in elderly men

Half an hour of physical activity for six days a week linked to 40% lower risk of death in elderly men and the impact on health is as good as giving up smoking, suggests a large 12-year Norwegian study. Men who regularly engaged in moderate to vigorous physical activity during their leisure time lived five years longer, on average, than those classified as sedentary.

Refusals to treat Compensation Fund patients

Doctors and medical practitioners across South Africa are refusing to treat Compensation Fund patients because of its failure to settle claims, research for the Democratic Alliance (DA) has shown. Government hospitals have also turned patients away.

Pricey cancer drugs gets rushed approvals despite poor trials

Highly priced cancer drugs get rushed approvals from benign regulatory authorities, despite poor trial methodology and little effect on the longevity of patients, cautions a British-American study. Unlike most other diseases, cancer instils a special fear and 'is treated as an evil, invincible predator, not just a disease', the authors note. Researchers compared 8942 oncology clinical trials conducted between 2007 and 2010 with trials for other diseases. Trials for cancer drugs were 2.8 times more likely not to be randomised, 2.6 times more likely not to use a comparator (single arm), and 1.8 times more likely not to be blinded.

High-protein risk for weight gain and heart disease

High-protein food diets — such as the Atkins Diet — actually increase the risk of putting on weight and even dying for people at high risk of heart disease, suggest Spanish study of 7,447 people. Although diets high in protein have become increasingly popular, there has been mixed evidence about their efficacy, and fears they could increase the risk of heart disease.

High fibre African diet reduces colon cancer risk

American and African volunteers swopping diets for just two weeks had dramatic effects on risk factors for colon cancer. Western diets, high in protein and fat but low in fibre, are thought to raise colon cancer risk compared with African diets high in fibre and low in fat and protein. The study confirmed that a high fibre diet can substantially reduce risk.

Minister laments lack of interest in prevention campaigns

The South African government's recent introduction of two new childhood vaccines has slashed the number of cases of life-threatening pneumonia and rotavirus, yet these successes have been barely acknowledged, says Minister of Health Aaron Motsoaledi. Business Day reports that delivering his budget speech to Parliament, Motsoaledi lamented that public discourse placed too much attention on events in hospitals and clinics. 'Any one negative event that takes place there is almost immediately regarded as the collapse of the health system,' he said.

Right-to-die judgment under siege

[caption id="attachment_4198" align="alignright" width="300"]Stransham-Ford2.jpgRobin Stransham-Ford last week and In better days - Pics courtesy of Netwerk24[/caption]Despite a landmark North Gauteng High Court ruling in favour of a man who wanted his doctors to be granted permission to help him die, the 'right-to-die' remains elusive for South Africans who are terminally ill. Health Minister Aaron Motsoaledi's said giving doctors the right to end a life is 'dangerous' and that the Health Department will now join hands with the Department of Justice and Constitutional Development to appeal the judgment. The South African Medical Association (Sama) has warned that even if the law were to permit medical practitioners to help patients end their lives, the ethical rules of the Health Professions Council of SA (HPCSA) would not allow this and such a doctor would face disciplinary action. Judge Hans Fabricius suggested Parliament should give ‘serious consideration’ to introducing a draft law legalising euthanasia. This MedicalBrief report contains also access to the full judgment.

Heart stopping news for polygamists

[caption id="attachment_4121" align="alignright" width="300"]ZumaPic courtesy of Timeslive
President Jabob Zuma with four of his wives[/caption]Polygamy increases the risk of heart disease by more than fourfold, reveals Saudi Arabian research. The risk and severity of heart disease increased with the number of wives. Dr Amin Daoulah, a cardiologist at the King Faisal Specialist Hospital and Research Centre in Jeddah, Saudi Arabia, whose multicentre observational study was presented at the Asian Pacific Society of Cardiology Congress 2015, said ‘This could be because the need to provide and maintain separate households multiplies the financial burden and emotional expense. Each household must be treated fairly and equally, and it seems likely that the stress of doing that for several spouses and possibly several families of children is considerable.’

New HCV treatment guidelines

The European Association for the Study of the Liver (EASL) has released its latest hepatitis C treatment guidelines.

HBV vaccination must be expanded

The universal infant hepatitis B virus (HBV) vaccination needs further expansion to significantly reduce HBV transmission and liver disease mortality, according to an Imperial College London analysis.

NASH has 50% higher death rate than NAFLD

A population-based cohort of almost a million people in the UK found that the chances of dying from non-alcoholic steatohepatitis (NASH), over a 14-year period, was approximately 50% higher than for those with non-alcoholic fatty liver disease (NAFLD).

In-patient cirrhosis deaths plummet

The largest US sampling to date found 'dramatic improvements' in the survival of patients with cirrhosis and liver failure.

NAFLD promotes coronary artery calcification

Non-alcoholic fatty liver disease (NAFLD) plays a role in the early stages of coronary atherosclerosis and in its more severe form it can also promote the development of coronary artery calcification (CAC).

HCV increases cancer risk 'significantly'

Cancer rates in patients with the hepatitis C virus (HCV) were significantly increased compared to the non-HCV cohort.

50th International Liver Conference, Vienna, Austria

motsoalediSome research highlights from the European Association for the Study of the Liver’s 50th International Liver Conference, including a potential cure for hepatitis B virus infections, with a promising new treatment proving 100% successful in pre-clinical models and new hepatitis C virus treatment guidelines.

HCV combination therapies show promise

A number of new HCV combination therapies show promise.

Potential cure for HBV

Australian scientists have found a potential cure for hepatitis B virus (HBV) infections, with a promising new treatment proving 100% successful in eliminating the infection in pre-clinical models.

Fat Blocker moves to silence fact checker

HarrisDr Harris Steinman, a medical doctor and consumer activist who runs a South African website exposing misleading claims about health products, has been forced to move his site offshore after sports supplement company USN demanded his internet service provider (ISP) take down his  CAMcheck site because it was ‘unlawful’. Steinman has long been a thorn in the flesh of complementary and alternative medicines (CAM) manufacturers because of his success in using the Advertising Standards Authority to remove or change misleading advertising. IT specialist Kevin Charleston says that this is the latest tactic by CAM manufacturers to silence critics. Some also were using intimidatory and expensive suits (so called SLAPP suits) to intimidate.

The world’s men beat a path to Tygerberg’s door

transplantSU The doctors at Tygerbeg Hospital who carried out the first successful p enis transplant on a patient who had a botched traditional circumcision, have been inundated with requests from men around the world who want to have the operation. Stellenbosch University doctors said the procedure could eventually be extended to men who have lost the organ from p enile cancer. In other p enile research at King's College London, researchers reviewed studies of p enis measurements for more than 15,000 men, the largest collection yet, to come up with a graph that can be shown to men who wonder, or obsess over, how theirs measure up.

Malpractice lawyers, HPCSA, hospital CEOs and private healthcare – all under fire

Aaron

Health Minister Dr Aaron Motsoaledi has in short order sharply criticised medical malpractice lawyers, instituted an inquiry into the Health Professions Councils of SA (HPCSA), another into state hospital CEOs, and been highly critical of specialists and private hospital groups: * State hospital CEOs are in cahoots with malpractice lawyers, says Motsoaledi, ‘deliberately failing to apply norms and standards’, hoping something would go wrong. They then colluded with state attorneys to deliberately ‘mismanage ... so that we lose the case’. The SA Medical Association notes ‘several cases where nurses and admin clerks are being investigated for selling patient files to lawyers specialising in malpractice’. * Motsoaledi has appointed a six-person panel to investigate claims of poor governance and mismanagement at the HPCSA. * Motsoaledi has blamed ‘profit-maximising specialists and hospitals’ for the high cost of medical care in the DOH submission to the Competition Commission inquiry into private healtcare.

Summary report drawn from City Press, Polity, HPCSA, Politicsweb, Moneyweb and DOH material

Campaign against 'too much medicine'

Summary drawn from Business Day, Citizen, IOL and Health ministry materials As part of a campaign against 'too much medicine' The British Medical Journal has published reviews that question the value of screening for breast cancer in women and aneurysm in men – asking whether the harm of 'over-diagnosis' outweighs the benefits of early detection and treatment of real cases. In similar vein,  in a recent JAMA Internal Medicine review of 36 studies on a range of medical interventions — from cancer screening tests to medications and surgeries — researchers discovered that, overwhelmingly, patients overestimated the benefits and underestimated the harms.

Global food giants revisit use of antibiotics

Global restaurant chain McDonald's is to reduce antibiotic use in its chicken products. It will remove antibiotics that can have an impact on human health, but keep those necessary for poultry welfare. Also, its dairy products would be derived from cows that have not been treated with the artificial growth hormone, rbST.

‘National crisis’ in obs/gynae, neurosurgery, neonatology and orthopaedics

Aaron Summary drawn from Business Day, Citizen, IOL and Health ministry materials Dr Aaron Motsoaledi has accused personal injury lawyers of creating a ‘national crisis’ similar to that which collapsed of the Australian health system 15 years ago, with doctors scared of certain specialist areas. The government faces contingent liabilities of R25bn for medical malpractice lawsuits, while private sector doctors are battling to keep up with steeply rising premiums for professional indemnity cover. Some medical specialities are ‘continually, persistently, and mercilessly being targeted for litigation’, said Motsoaledi, noting that he would like to see some public hospitals CEOs arrested for being part of syndicates that were looting funds.