GP’ s five-year ordeal is over from page 1
Mandatory reporting
News
Caution urged over birth defect discovery
The study has great potential, claims Professor Dunwoodie. |
MICHAEL WOODHEAD AUSTRALIAN researchers are claiming an extraordinary breakthrough showing that vitamin B3 may prevent miscarriage, but other experts are urging caution over the preliminary findings.
In what they describe as“ one of the greatest discoveries in pregnancy research”, scientists at Sydney’ s Victor Chang Cardiac Research Institute say niacin
|
|
|
|
|
( vitamin B3) can cure the molecular deficiencies that cause miscarriages and birth defects.
They say their discovery in mouse experiments paves the way for women to take vitamin B3 in pregnancy.
“ This has the potential to significantly reduce the number of miscarriages and birth defects around the world, and I do not use those words lightly,” said
|
researcher Professor Sally Dunwoodie.
The study showed that congenital malformations in mice were linked to a deficiency of nicotinamide adenine dinucleotide( NAD) caused by two mutant genes. It also showed that niacin supplementation prevented the malformations.
“ We believe that this breakthrough will be one of our country’ s greatest
|
medical discoveries,” said Professor Robert Graham, executive director of the institute.
“[ This ] suggests that it is probably best for women to start taking vitamin B3 very early on, even before they become pregnant,” he added.
However, Associate Professor David Amor, a clinical geneticist at the Victorian Clinical Genetics Services,
|
stressed that the findings related to a rare genetic condition.
“ A broader question is whether dietary niacin deficiency might play a role in birth defects even in the absence of the genetic deficiency of NAD, and whether dietary supplementation of niacin might be of benefit to pregnant women in the general population,” Professor Amor said.
|
1 – 3
YOUR TRAVEL ADVICE IS THE LAST THING ON HIS MIND Up to 98 % of travellers fail to adhere to safe eating and drinking advice whilst abroad 1
ANTICIPATE
VACCINATE 5
HELP PROTECT AT-RISK TRAVELLERS AGAINST DIARRHOEA CAUSED BY CHOLERA. 4, 5 85 % protective efficacy against cholera demonstrated at 6 months after primary course. 5
PBS Information: This product is not listed on the National Immunisation Program( NIP) or the PBS.
Oral, Inactivated Cholera vaccine
Before prescribing, please review Product Information at www. seqirus. com. au. com / PI
MINIMUM PRODUCT INFORMATION. DUKORAL ® Oral Inactivated Cholera Vaccine. INDICATIONS: Cholera caused by serogroup O1 Vibrio cholerae: Active immunisation of adults and children ≥ 2 years of age, who will be visiting areas epidemic or endemic for cholera and who are at high risk of infection. CONTRAINDICATIONS: None known. PRECAUTIONS: Postpone immunisation in cases of acute illness; Not protective against species other than O1 V. cholera; Does not necessarily prevent spread of cholera via a vaccinee exposed to V. cholerae bacteria; Not a sole measure in prevention of cholera outbreaks. Encourage clean hygiene practices; Subjects infected with HIV; Pregnancy Category B2. Use in Lactation: DUKORAL may be administered to lactating women. INTERACTIONS: Avoid food / drink 1 hour ± vaccination; Buffer may affect other oral vaccines. Administration of encapsulated oral typhoid vaccine should be separated by ≥ 8 hours. ADVERSE EFFECTS: Abdominal discomfort, loose stools, headache, rhinitis, cough or other respiratory symptoms( see full PI). DOSAGE & ADMINISTRATION: Dissolve effervescent granules in 150mL water( pour away 75mL for children 2 – 6 years), mix DUKORAL suspension with buffer solution and drink. Adults, children > 6 years: 2 doses; Children 2 – 6 years: 3 doses; administer doses at intervals ≥ 1 week. Re-start basic immunisation if > 6 weeks elapse between doses. Booster: Adults, children > 6 years: 2 years; Children 2 – 6 years: after 6 months. PRESENTATION: Whitish oral liquid suspension( vaccine) in a single dose glass vial with effervescent granules( buffer), in an accompanying sachet. STORAGE: Store at 2˚C to 8˚C. Refrigerate, do not freeze. Based on TGA approved PI dated 9 September 2003, last amended 6 August, 2015. REFERENCES: 1. Kozicki M et al. Int J Epidemiol. 1985; 14( 1): 169 – 172. 2. Mattila L et al. J Travel Med 1995: 1; 2( 2): 77 – 84. 3. Steffan R et al. Trav Med Infect Dis. 2003; 1:80 – 88. 4. NHMRC. The Australian Immunisation Handbook 10th Edition. 2013. 5. DUKORAL ® Approved Product Information, August, 2015. Product Information is available from Seqirus( Australia) Pty Ltd. 63 Poplar Road, Parkville, VIC 3052. ABN 66 120 398 067. Medical Information: 1800 642 865. ® DUKORAL is a registered trademark of Valneva Sweden AB. Seqirus™ is a trademark of Seqirus UK Limited or its affiliates. Date of preparation: July 2017. SEQ / DUKO / 0517 / 0050a. 14259-AD.
GP’ s five-year ordeal is over from page 1
However, the judge found that despite Mrs Coote’ s claims, she had been mistaken about pigmentation in the lesion.
“ At the time that Mr and Mrs Coote made their initial observations of a small lesion on Mr Coote’ s foot, they had no reason to believe that there was anything sinister or suggestive of a malignant tumour.
“ Although Mrs Coote was later to say that the lesion did not look like a plantar wart to her, at the time when she knew that her husband’ s general practitioner had so diagnosed it and was treating it, over many months, she did not even suggest obtaining a second opinion.
“ That is not to be critical; it is merely to note that, at the time the early observations were made, the whole affair was treated as mundane.”
Medical negligence lawyer Gemma McGrath, a partner at Panetta McGrath in Perth, WA, said:“ If Dr Kelly had written down an observation of the wart this case may not have gone as far as it did.
“ The difficulty is that lawyers will always say write it down or draw a diagram in your medical notes. If the case highlights anything, it is that just because you think it is a wart, it may not be. If things aren’ t responding to treatment the way you would expect, it is always important to keep thinking what else could it be.”
Mandatory reporting
from page 1 scrapping mandatory reporting shouldn’ t be the end of the conversation.
“ I really welcome the changes to mandatory reporting, but as a profession, we risk conflating mandatory reporting with doctors’ suicide,” she said.“ And we are kidding ourselves if we think that changes to mandatory reporting are going to be the answer to doctors’ suicide.”
6 | Australian Doctor | 18 August 2017 www. australiandoctor. com. au