Leukaemia clue in breast cancer








Doctor examines breast X-ray


Leukaemia research may lead to new drugs for difficult-to-treat breast cancers, say scientists.

These types of tumours cannot be treated with the targeted drugs which have hugely improved survival.

A team in Glasgow says a faulty piece of DNA which causes leukaemia also has a role in some tumours and could help in research for new drugs.

Meanwhile, other researchers say they have taken tentative steps towards a blood test for breast cancer.

Oestrogen or progesterone positive breast cancers can be treated with hormone therapies such as Tamoxifen.

Another drug, Herceptin, works only on those tumours which are HER2-positive.

But around one in five breast cancers is “triple negative” meaning chemotherapy, radiotherapy or surgery are the only options.


Leukaemia

A team at the University of Glasgow investigated the role of the RUNX1 gene, which is one of the most commonly altered genes in leukaemia.

However, they have now shown it is also active in the most deadly of triple negative breast cancers.

Tests on 483 triple negative breast cancers showed patients testing positive for RUNX1 were four times more likely to die as a result of the cancer than those without it.

The results were published in the journal PLoS One.

One of the researchers, Dr Karen Blyth, said: “This opens up the exciting possibility of using it [RUNX1] as a new target for treatments.”

She told the BBC: “First we need to prove this gene is causative to the cancer, if it is then what would happen if we did inhibit it?

“There’s a couple of drugs in development in the US to target this gene from a leukaemia point of view, if they work we can test it in breast cancer cells.”


Breast cancerCould leukaemia lead to insight into breast cancer?

However, the gene has a complex role. Normally it is vital for cell survival and plays a critical role in producing blood. However, depending on circumstances, it can either encourage or suppress tumours.

It means any use of a drug to target the gene might cause side-effects.

Dr Kat Arney, the science communications manager at Cancer Research UK, said: “There’s still so much we need to understand about triple negative breast cancers, as they can be harder to treat in some people.

“Almost two out of three women with breast cancer now survive their disease beyond 20 years.

“But more must be done and we urgently need more studies like these, particularly in lesser-understood forms of the disease, to build on the progress we’ve already made and save more lives.”


Blood test

In a separate development, scientists at University College London think they have taken the first steps towards a blood test for breast cancer.

They found changes in the DNA of immune cells in the blood of women who were at high risk of breast cancer as they had inherited the BRCA1 risk gene.

Prof Martin Widschwendter, from UCL said: “Surprisingly, we found the same signature in large cohorts of women without the BRCA1 mutation and it was able to predict breast cancer risk several years before diagnosis.”

They think it could become the basis of a blood test.

Dr Matthew Lam, senior research officer at Breakthrough Breast Cancer, said: “These results are definitely promising and we’re excited to learn how further research could build on these findings.”

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Call to halve target for added sugar








By James Gallagher
Health editor, BBC News website


Sugar cubesSugar: There are growing concerns about sugar and health


People need to more than halve their intake of added sugar to tackle the obesity crisis, according to scientific advice for the government in England.

A draft report by the Scientific Advisory Committee on Nutrition (SACN) says sugar added to food or naturally present in fruit juice and honey should account for 5% of energy intake.

Many fail to meet the old 10% target.

The sugar industry said “demonising one ingredient” would not “solve the obesity epidemic”.

The body reviewed 600 scientific studies on the evidence of carbohydrates – including sugar – on health to develop the new recommendations.

One 330ml can of fizzy pop would take a typical adult up to the proposed 5% daily allowance, without factoring in sugar from any other source.
















Jeremy Paxman with a can of Coca-cola









Coca Cola Europe boss James Quincey confronted by Newsnight’s Jeremy Paxman in November 2013








Prof Ian MacDonald, chairman of the SACN working group on carbohydrates, said: “The evidence that we have analysed shows quite clearly that high free sugars intake in adults is associated with increased energy intake and obesity.

“There is also an association between sugar-sweetened beverages and type-2 diabetes.

“In children there is clear demonstration that sugar-sweetened beverages are associated with obesity.

“By reducing it to 5% you would reduce the risk of all of those things, the challenge will be to get there.”

The target of 5% of energy intake from free sugars amounts to 25g for women (five to six teaspoons) and 35g (seven to eight teaspoons) for men, based on the average diet.


Daily added sugar intake by age group


‘Silver bullet’

Public Health England will now reconsider its recommendations on fruit juice and smoothies in its five-a-day campaign.

The current advice from the NHS is that juice counts as a maximum of one portion a day, while a smoothie may count as more than one portion, depending on how it is made.

It will also investigate measures to protect children from food advertising while online and whether a sugar tax would have any merit.

Dr Alison Tedstone, the chief nutritionist at Public Health England, said: “We are very concerned around sugar intakes in England.

“It doesn’t mean having a completely different diet from today, it is thinking about swapping high sugar foods for a lower sugar alternative.

“Instead of fizzy drink, have water or low-fat milk, instead of a chocolate bar, have a piece of fruit.”


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Analysis

By James Gallagher, Health editor, BBC news online


Orange juice

There’s something noticeably missing from a call to halve added sugar – how would you go about doing it?

This group was set up to assess the science and determine what we should be eating. Its role was not to come up with policies.

The target of 5% is a huge challenge when teenagers are currently getting 15% of their calories from added sugar.

One option that doctors have called for is a tax on sugary drinks. The measure is being tried in Mexico, although there is still little evidence on its impact.

The tough decisions are all still to come – what measures will the public accept and how can we be encouraged to eat less sugar without driving us back into the arms of saturated fat and salt?

BBC News: Five foods surprisingly high in sugar

BBC News: The family that gave up sugar


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The SACN advice echoes an announcement by the World Health Organization in March.

Its draft guidelines reiterated that sugars should constitute no more than 10% of energy intake and that people and governments should be aiming for 5%.

The limits would apply to all sugars added to food, as well as sugar naturally present in honey, syrups, fruit juices and fruit concentrates.

The Food and Drink Federation, which represents manufacturers, said: “SACN’s comprehensive analysis of the evidence on carbohydrates has looked at the role of carbohydrates, including sugars and fibre in the diet. We will look at the content of the report and its recommendations over the next few weeks with the intention of engaging in the consultation process and related discussions.”

Dr Julian Cooper, head of food science at AB Sugar, said targeting sugar was not a “silver bullet” and people should balance their calorie intake against how much they exercise.


‘Fantastic’

The campaign group, Action on Sugar, said the development was “fantastic” news.

The group’s chairman Prof Graham MacGregor argued: “{Health Secretary Jeremy Hunt must start by setting targets for reducing sugar in soft drinks this summer and move responsibility for nutrition to an independent body such as the Food Standards Agency so that the soft drinks and food industry are given a level playing field, with the threat of regulation to ensure the whole of the food industry comply.

“Before another million British kids become obese.”

Public Health Minister for England, Jane Ellison, said: “We know eating too much sugar can have a significant impact on health, and this draft advice confirms that.

“We want to help people make healthier choices and get the nation into healthy habits for life. This report will inform the important debate taking place about sugar.”

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CDC recommends combo HIV test for faster detection of virus


(Reuters) – The U.S. Centers for Disease Control and Prevention (CDC) said on Thursday it has recommended a new type of HIV testing that utilizes diagnostics that can detect infection up to three to four weeks faster, potentially preventing the spread of the virus that causes AIDS.

The CDC is recommending so called HIV combination tests that can detect the virus as well as specific antibodies in the blood that would show the body is reacting to the presence of the virus.

Currently available HIV combo tests are made by Abbott Laboratories and Alere Inc.

Nearly 1 in 6 people living with HIV in the United States do not know they have the virus, according to the CDC. That means they may unknowingly transmit the virus as well as be delaying treatment for themselves.

Roughly half of the estimated 50,000 new HIV infections each year are transmitted by people who do not know they are HIV-positive, the CDC said.

Speedier diagnosis is critical since many new infections are transmitted by people in the earliest stage of infection, the CDC said.

“With consistent and widespread use of this new testing method, we can diagnose people several weeks earlier than before,” the CDC said in a statement, adding that it is encouraging medical testing laboratories to adopt the new approach as quickly as possible.

(Reporting by Bill Berkrot)

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Auxilium Pharmaceuticals plans to merge with QLT

Auxilium Pharmaceuticals, Inc. (NASDAQ: AUXL), a fully integrated specialty biopharmaceutical company, and QLT Inc. (NASDAQ: QLTI) (TSX: QLT), a Canadian-based biotechnology company focused on developing innovative orphan ophthalmology products, today announced that they have entered into a definitive agreement under which Auxilium plans to merge with QLT. The transaction is expected to drive shareholder value creation by accelerating Auxilium’s ongoing transformation into a leading diversified North American specialty biopharmaceutical company. As a result of the merger, Auxilium expects to have an expanded corporate platform that includes focused investments in research and development and the continued pursuit of new products and M&A due to cost and tax synergies. The companies also intend to continue to pursue a potential partnering agreement for QLT’s promising late-stage retinoid program.

Under the terms of the agreement, a wholly-owned subsidiary of QLT will be merged with and into Auxilium. QLT will remain incorporated in British Columbia, Canada, and will be renamed “New Auxilium.” Current shareholders of Auxilium will receive 3.1359 QLT shares for each Auxilium share, subject to certain adjustments. For QLT shareholders, the transaction represents a 25% premium based on a calculation of the closing NASDAQ stock prices of Auxilium and QLT on June 25, 2014, the last trading day prior to the announcement of the merger. When completed, Auxilium shareholders will own approximately 76% of the combined entity on a fully diluted basis, and current QLT shareholders will own approximately 24%, subject to certain adjustments.

Adrian Adams, Chief Executive Officer and President of Auxilium, stated, “Building on Auxilium’s strong foundation and commercial expertise, the merger with QLT represents a unique opportunity to accelerate our desired strategic transformation into a leading, diversified North American specialty biopharmaceutical company. We are creating what we believe is a more competitive and efficient platform to capitalize on greater market opportunities and position Auxilium to deliver meaningful value for shareholders while enhancing our ability to invest in and offer innovative products that make a difference in the lives of underserved patients.”

“We believe that this is an excellent transaction for QLT shareholders and provides them with the opportunity to benefit from the potential upside of the combined company,” said Jason Aryeh, Chairman of QLT. “We believe that Adrian Adams and the Auxilium team have proven their ability to execute and deliver on a strategy for providing quality specialty biopharmaceutical products to fill significant unmet medical needs around the world. I am confident that under their leadership, and with the advantages presented by our combined organization, this transaction will leave the merged company well-positioned to achieve sustained growth.”

The combined organization will be led by Auxilium’s current leadership team and will maintain Auxilium’s current offices in Chesterbrook, Pennsylvania. All current Auxilium directors are expected to join the merged company’s board, joined by two current QLT directors. Auxilium does not expect any material changes to its current U.S. operations or employment as a result of this transaction, and expects to grow its presence in both the U.S. and Canada. Shares of the combined company are expected to trade on NASDAQ and QLT is expected to be delisted from the Toronto Stock Exchange.

Mr. Adams continued, “We believe this transaction will facilitate the continued build out of our current portfolio and provide us with the corporate platform and strong financial position to build on our strength in men’s healthcare and enable expansion into new specialty therapeutic focus areas. The transaction aligns with Auxilium’s well-defined growth strategy and our intention to build a more diversified global organization through the aggressive pursuit of product licensing and M&A. We expect Auxilium to create increased value for shareholders and patients for years to come.”

QLT Retinoid Program

QLT’s synthetic retinoid program is a replacement for 11-cis-retinal and is under development for the treatment of retinal diseases caused by gene mutations that interfere with the availability of 11-cis-retinal. QLT has conducted safety and proof of concept clinical studies to evaluate its oral synthetic retinoid in patients with Leber Congenital Amaurosis (LCA) or Retinitis Pigmentosa (RP). The innovative ophthalmology program is nearing Phase 3 development. With its orphan drug designation, QLT’s synthetic retinoid program augments Auxilium’s existing orphan drug portfolio and allows Auxilium to expand its orphan drug reach outside of the U.S. Auxilium and QLT intend to continue to pursue discussions around a potential partnering agreement for this promising late-stage retinoid program.

Approvals and Further Details

The transaction, which has been unanimously approved by the Boards of both companies, is subject to certain conditions and approvals, including regulatory approvals in the U.S. and Canada, if necessary, the approval of both companies’ shareholders, consents under Auxilium’s senior secured credit facility required as a result of the transaction or, in lieu of such consents, the refinancing of such facility, receipt of an opinion of counsel to Auxilium that “New Auxilium” should not be treated as a U.S. domestic corporation for U.S. federal income tax purposes, and other negotiated closing conditions. Deutsche Bank has delivered a commitment letter for a $225 million facility for the refinancing of the senior secured credit facility (together with cash on hand) that is subject to the execution of definitive agreements and other conditions. The transaction is expected to close in the fourth quarter of 2014, and is expected to be taxable to Auxilium shareholders. Holders representing approximately 32% of QLT shares outstanding have agreed to vote in favor of the transaction.

Deutsche Bank, Skadden Arps and Morgan Lewis acted as advisors to Auxilium. Houlihan Lokey Financial Advisors, Inc. also acted as an advisor to Auxilium. Credit Suisse, McCullough O’Connor Irwin LLP, Nutter McClennen & Fish LLP and KPMG LLP acted as advisors to QLT.

Source:

Auxilium Pharmaceuticals, Inc.

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Campaigners lose 'right to die' case





















Paul Lamb









Paul Lamb: “I haven’t committed a crime, I don’t deserve to be punished like this”








Campaigners have lost their appeal at the UK Supreme Court over the right to die – but the judges said Parliament should now act.

Justices ruled against Paul Lamb and Jane Nicklinson by seven to two.

A third man, Martin, lost his attempt to have the current prosecution guidance on assisted suicide clarified.

But five justices concluded they had the power to declare the current law breaches the right to a private life.

Had the court made such a declaration, it would have forced the government to introduce legislation to amend the law on assisted suicide in England and Wales.

A majority of the justices said that the question they were being asked involved moral judgements rather than points of law – and the matter had to be addressed by a democratically-elected Parliament.

The cases involve the family of the late Tony Nicklinson, of Wiltshire, who had locked-in syndrome, and Paul Lamb, of Leeds, who was paralysed in a road crash.

They wanted the law changed to allow doctors to assist patients to die.

Nine justices had to decide whether a prohibition on assisted suicide was compatible with the right to respect for private and family life under the European Convention on Human Rights.

Five concluded the court had the “constitutional authority” to make a declaration, and two of the five said they would have done so.


‘Positive step’

Mr Lamb and Mrs Nicklinson, the wife of Tony Nicklinson, said the conclusions were a “positive” step in the fight for change.

“I am very proud of myself,” said Mr Lamb, 58. “I know it is going to change.”

Mrs Nicklinson, from Wiltshire, whose husband Tony died aged 58 last year, added: “I am disappointed that we lost. But it is a very positive step. Parliament will have to discuss this. I think Tony would be very pleased at how far we have come.”

Commenting on the ruling, Andrea Williams of Christian Concern, said: “This is good news for the many vulnerable people who would have been at risk if the attempt to weaken the law on euthanasia and assisted suicide had been allowed by the Supreme Court.”

Andrew Copson, chief executive of the British Humanist Association, which supported the campaigners, said: “It is clear that the Supreme Court went as far as it was able in urging Parliament to take action on the vital issue of assisted dying.”

A third man, known only as Martin, was seeking clarification of the Director of Public Prosecutions’s (DPP’s) guidance on the position of health professionals who assist a suicide.

Martin wants it to be lawful for a doctor or nurse to help him travel abroad to die with the help of a suicide organisation in Switzerland. His wife and other family want no involvement in his suicide.

The Supreme Court unanimously allowed the DPP’s appeal against a previous Court of Appeal ruling in Martin’s favour for clarification of the guidance.

Using an adapted computer operated by sight, Martin said in a statement: “I would implore the DPP to amend her written guidance as a matter of absolute priority.

“People in my situation, who have the right to choose how to end their lives, should be able to get the assistance they need from people outside their family.”


Tony NicklinsonTony Nicklinson suffered from locked-in syndrome


Long battle

Mr Lamb has been almost completely paralysed from the neck down since a car accident more than 20 years ago and says he is in constant pain.

He has called for the law to be changed so any doctor who helped him die would have a defence against the charge of murder.

Tony Nicklinson was paralysed from the neck down after suffering a stroke while on a business trip to Athens in 2005.

After losing his High Court battle last year, he refused food and died naturally, aged 58, a week later at his home in Wiltshire. His widow, Jane, is continuing his legal battle.
















Lord Carlile









Lord Carlile said the UK offered “the best palliative care in the world”, and there was no case for a law allowing assisted suicide








The 1961 Suicide Act makes it an offence to encourage or assist a suicide or a suicide attempt in England and Wales. Anyone doing so could face up to 14 years in prison.

But despite this, scores of UK citizens have travelled to Dignitas in Switzerland to end their lives – and no relative who has helped them has faced prosecution.

The law is almost identical in Northern Ireland.

There is no specific law on assisted suicide in Scotland, creating some uncertainty, although in theory someone could be prosecuted under homicide legislation.

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Jab 'protects mice against tumours'








By Helen Briggs
Health editor, BBC News online


The most common site for gliomas is the brainA malignant brain tumour is a fast-growing cancer that spreads to other areas of the brain and spine


Scientists have developed a vaccine that they say provides some protection against brain tumours in mice.

The vaccine works by boosting the immune system to attack abnormal cells.

The approach has not been tested on humans, but clinical trials could begin next year in Germany, say researchers.

Brain tumours are difficult to treat so more research is urgently needed to give patients better options, said a cancer charity.

A team at the National Centre for Tumour Diseases in Heidelberg developed a vaccine that targets brain tumour cells.

It is based on the natural ability of some patients with brain tumours to mount an immune response against the disease – although this is not enough to stop the tumour growing.

The mouse experiment showed that a vaccine may be able to boost this natural approach, the researchers said.

“We can induce an immune response that is similar to what we see in some brain tumour patients who have a natural immunity but it is not strong enough to take care of the tumour,” said Prof Michael Platten.

The team is applying for approval to start a human clinical trial in Germany next year.


‘Exciting approach’

“It’s still too early to know if the vaccine will be efficacious in humans,” he added.

The charity Cancer Research UK described the research, published in Nature, as “exciting”.

“Using the immune system to attack cancer is an exciting approach to tackling the disease and this research is another step forward in finding new treatments,” said Dr Emma Smith, senior science information officer.

“But this is a very early-stage study and was carried out in mice, so much more research is needed before we know if the vaccine is safe or effectively boosts an immune response against brain tumours in people.

“Brain tumours are a diverse group of cancers and are difficult to treat, so we urgently need more research to give people better options.”

Other researchers around the world are looking into similar vaccines to stimulate the immune system to fight off cancer.

A trial started in the UK last year into a similar vaccine to fight brain tumours.

The approach, known as immunotherapy, is also being tested in the US.

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White House weakened draft of FDA's proposed tobacco regulations

A man uses an E-cigarette, an electronic substitute in the form of a rod, slightly longer than a normal cigarette, in this illustration picture taken in Paris, March 5, 2013. REUTERS/Christian Hartmann

A man uses an E-cigarette, an electronic substitute in the form of a rod, slightly longer than a normal cigarette, in this illustration picture taken in Paris, March 5, 2013.

Credit: Reuters/Christian Hartmann


(Reuters) – White House changes to proposed rules for tobacco products significantly weakened language detailing health risks from cigars and deleted restrictions that might have prevented online sales of e-cigarettes, published documents show.

The White House’s Office of Management and Budget (OMB), which analyzes the potential economic consequences of proposed regulations, deleted language in the U.S. Food and Drug Administration’s recently proposed regulations describing how the rules would keep thousands of people from taking up cigar smoking and have enormous public health benefits.

The OMB also weakened language detailing the FDA’s concerns about the safety of e-cigarettes, according to documents published Tuesday in the Federal Register.

Emily Cain, a spokeswoman for OMB, said that as with any rule, OMB’s office of information and regulatory affairs conducted an interagency review process “to ensure that the regulations through which agencies implement policies are efficient, well-designed to achieve their objectives, and based upon the best available evidence.”

“It is routine for agencies to make changes to their draft rules during the course of OMB review,” she added. “The goal is to maximize the effectiveness and benefit of the rules we complete.”

An FDA spokeswoman, Jennifer Haliski, said the FDA does not comment on changes to a proposal during the review process but said the period for the public to comment on the proposal is still open until Aug. 8.

“All comments will be carefully considered as the final rule is being developed,” she said in an email. “As the science base continues to develop for these products, the agency has the ability to take additional regulatory actions designed to further minimize the public health burden of tobacco use in this country.”

The FDA has authority under a 2009 law to regulate cigarettes, smokeless tobacco and roll-your-own tobacco, but must issue new rules before regulating e-cigarettes, cigars, hookahs, water pipes and other tobacco products.

In April, the FDA issued a proposal which would subject the $2 billion e-cigarette industry to federal regulation for the first time. It would ban the sale of e-cigarettes to people under the age of 18 and vending machine sales.

The proposal disappointed public health advocates who criticized the agency’s failure to restrict flavored products or television advertising, which they say attracts children, and criticized the agency for not moving to restrict online sales, where it can be harder to verify a person’s age.

In its draft, the FDA had proposed “prohibition of non-face-to-face sales (e.g. vending machines).” That would have opened the door to a ban on online sales. But OMB edited the sentence so that the prohibition refers only to vending machines.

In another significant change, OMB turned the FDA’s proposal as it relates to cigars from a two-part rule – one for traditional tobacco products and one for products that have not previously been regulated – into a “two-option” rule, one of which would exempt “premium cigars.”

The cigar industry, backed by some members of Congress, had lobbied OMB heavily for such an exemption. In a December 2013 letter to FDA Commissioner Margaret Hamburg and Sylvia Mathews Burwell, who was director of OMB at the time and is now Secretary of Health and Human Services, 24 Republican lawmakers asked that premium cigars be exempt.

“As you know,” they wrote, “premium cigars are a niche product with an adult consumer base, much like fine wines. The majority of people who enjoy a cigar do so occasionally, often in social or celebratory settings.”

When the proposed rule came out in April, some public health advocates expressed dismay.

“The part of the proposal we are deeply troubled by is the sweetheart deal for the cigar industry,” Erika Sward, assistant vice president for national advocacy at the American Lung Association.

OMB also deleted an FDA analysis showing that exempting premium cigars from a proposal to require large warning labels would save manufacturers $1 million to $3 million but incur costs to public health of $32.6 million to $34.2 million.

The White House office also deleted an extensive section in which the FDA calculated how many lives would be saved by regulating cigars, as well as the value of those lives. And it deleted a similar analysis for the improvements in health that would come from dissuading people from smoking cigars, such as through warning labels.

The “welfare gain” from reducing the number of cigar smokers, FDA calculated, would be $16 million to $52 million.

Similarly, OMB modified or deleted FDA concerns about the safety of e-cigarettes, including manufacturing quality.

It deleted FDA draft language saying it would review electronic cigarette cartridges to respond to evidence of poor quality control, variable nicotine content or toxic ingredients such as diethylene glycol, a chemical that the FDA said has caused mass poisonings in products such as the painkiller acetaminophen and cough syrup.

Last week a panel of U.S. senators excoriated the chiefs of two of the biggest e-cigarette companies, blu eCigs, which is owned by tobacco giant Lorillard Inc, and privately held NJoy, saying they were irresponsibly targeting children with advertisements depicting cartoon characters, movie stars and other celebrities.

Both companies defended the advertisements, saying they target adult smokers.

To see the edited proposal, click here under “Supporting Documents” www.regulations.gov/#!docketDetail;D=FDA-2014-N-0189.

(Reporting by Toni Clarke in Washington and Sharon Begley in New York; Editing by Clive McKeef)

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FDA warns of allergic reactions with popular acne products


(Reuters) – The U.S. Food and Drug Administration warned on Wednesday that popular acne products such as Proactiv and Neutrogena can cause rare but serious and life-threatening allergic reactions.

The FDA said consumers should stop using their topical acne product and seek emergency medical help if they experience hypersensitivity reactions such as throat tightness, difficulty in breathing, feeling faint or swelling of the eyes, face, lips or tongue. (1.usa.gov/TwSCNt)

The regulator said products marketed under brands such as Proactiv, Neutrogena, MaxClarity, Oxy, Ambi, Aveeno and Clean & Clear were of concern.

(Reporting by Esha Dey in Bangalore; Editing by Maju Samuel)

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Fears hospital mistakes covered up








By Nick Triggle
Health correspondent, BBC News


Hospital nursesThe Francis Inquiry identified a range of problems in the NHS


A fifth of hospital trusts in England may be covering up mistakes, a government review suggests.

The analysis of reporting incidents shows 29 out of 141 trusts were not registering the expected number of safety incidents.

The review said this may be a sign of a “poor” safety culture.

Health Secretary Jeremy Hunt said it was important hospitals were “open and honest”, and that patients had a right to know about problems with reporting.

The data has been released as part of the Department of Health and NHS England’s drive to improve safety in the NHS.

In March, Mr Hunt set the target of saving 6,000 lives over the next three years by reducing the number of serious mistakes.

He asked trusts to join the Sign up to Safety campaign and draw up plans to halve “avoidable harm” such as medication errors, blood clots and bedsores by 2016-17.

He said this could stop a third of preventable deaths in the coming years – equivalent to 6,000 lives saved.


Safe staffing

On Tuesday the government will launch the next stage of this campaign, a website which will allow patients to view the performance of individual hospitals on measures such as safe staffing levels and infection rates.

It will also reveal which trusts have been given a poor rating for open and honest reporting. This has been decided after reviewing the way trusts report safety incidents into the National Report and Learning System as well as looking at the results of the staff survey question relating to safety reporting.

Those with lower-than-expected incident reporting, which is widely acknowledged to be a sign of problems, will be followed up by NHS England officials.


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Nick Triggle – Health Correspondent BBC News

The latest announcement on patient safety makes alarming reading. One in five sounds like problems are widespread.

But what the government has done is essentially risk-profile – that is to say work out which trusts fall outside the expected range.

They do this by working out what average performance is. In this case, it is to do with how many safety incidents are reported.

Some leeway is then given to allow those who are just above or below the average to be grouped together in the expected range. This leaves a number of good and bad outliers – which, by definition, will be around 20% to 25% of the total.

This is a tried-and-tested method that has been used by groups such as Dr Foster for years. Indeed, the Care Quality Commission did it when they gave each hospital a risk rating last year. That time one in four fell into the “bad” category.

This, of course, is not the same as saying the trusts are risky. The government argues publicising its risk analysis in this way is about being open and honest. That maybe true, but the danger is that the subtleties of the message can get lost.


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Mr Hunt told BBC Radio 4’s Today programme that this was not about “humiliating” anyone.

“The NHS is there for patients and if a hospital has a problem with its reporting culture, I think patients have a right to know that,” he said.

The health secretary said if patients were aware of these problems, hospitals would be encouraged to take more speedy action.

The founder of the Clinical Human Factors Group, which campaigns for a safer NHS, warned that “simply naming and shaming” would not bring the best results.

Martin Bromiley, whose wife died in 2005 following a minor operation in hospital, said understanding why organisations were not reporting incidents was key.


Hospital Health Secretary Jeremy Hunt set the target of saving 6,000 lives over the next three years

“We need to try and understand the organisations that aren’t reporting,” he told the Today programme.

“We need to understand the cultures and what things they are doing that are not encouraging openness.”

Mr Bromiley said the best organisations were the ones that encouraged learning.

He said there might have been an “unconscious incompetence” when it came to those failing to be open because they did not understand the process of developing a “safety culture”.

The website is being hosted on the NHS Choices site and will be launched on Tuesday afternoon.

The Department of Health stressed that there could be justifiable reasons for low reporting, such as the trust being safe or innocently not using the recording system properly, but that it was only right the concerns be investigated further.


‘Avoidable harm’

Mr Hunt said: “The NHS is leading the world in achieving new safety standards but the battle to reduce avoidable harm is constant.

“Unsafe care causes immeasurable harm to patients and their families, and also costs the NHS millions in litigation claims.”

Sir David Dalton, the chief executive of Salford Royal Hospital and leader of the safety campaign, urged hospitals to be open.

“Healthcare carries inherent risk and while healthcare professionals work hard every day to reduce this risk every day, harm still happens.

“Some is unavoidable but most isn’t. Sign up to Safety seeks to reduce this harm and is a unique opportunity for us all to work together to listen, learn and act to make a difference.”

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USPSTF Finalizes AAA Guidance

Todd Neale, MedPage Today Staff Writer, got his start in journalism at Audubon Magazine and made a stop in directory publishing before landing at MedPage Today. He received a B.S. in biology from the University of Massachusetts Amherst and an M.A. in journalism from the Science, Health, and Environmental Reporting program at New York University.

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