GP ’ s five-year ordeal is over from page 1
Mandatory reporting
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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
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( 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
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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
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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 ,
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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 .
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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