Saturday, August 09, 2008

Common fertility treatments are 'no better than nature', study finds

Once again, conventional medical wisdom fails under test

Fertility treatments offered to couples trying for a baby are no more effective than attempts to conceive naturally, a study suggests today. Couples who attempt artificial insemination or use a drug designed to aid conception do not have significantly higher chances of a pregnancy than those not receiving treatment, the researchers found.

One in seven couples in Britain experiences problems conceiving, with about a quarter of these having unexplained infertility. Treatments are offered in line with fertility guidelines issued by the National Institute for Health and Clinical Excellence (NICE). They include artificial insemination, and the drug clomiphene citrate, which is believed to correct subtle ovulatory dysfunction. Such treatments are relatively inexpensive and do not involve stimulation of a woman's ovaries or IVF (in vitro fertilisation).

Researchers writing in the British Medical Journal, however, have thrown into question the provision of such treatments on the NHS. Intrauterine insemination (IUI) and clomiphene citrate (Clomifert or Clomid) are recommended for couples who have had difficulty conceiving, but where investigations have failed to find out why. Couples would typically be offered these methods before considering IVF, which involves collecting a woman's eggs, fertilising them outside the body and returning them to her womb.

For the study, 580 women who had been trying unsuccessfully to conceive for more than two years were recruited from four teaching hospitals and one general hospital in Scotland. One group of 193 women were given advice on having sex regularly but were left to try to conceive naturally. Another 194 women were given clomifene. The remaining 193 were given IUI, which is thought to enhance the chance of pregnancy by injecting sperm behind the cervical barrier. All treatments were followed for six months.

At the end of the study, there had been 101 live births - 32 among the 193 women trying to conceive naturally (17 per cent), 26 among those on the drug (14 per cent) and 43 among those having insemination (23 per cent). The researchers, from the universities of Aberdeen and Oxford, and hospitals in Edinburgh, Dundee, Falkirk and Glasgow, said that these differences were not significant enough to be attributed solely to treatment or lack of it. They suggested that the NHS could be wasting time and money on providing the therapies and called for the NICE guidelines to be reviewed.

Siladitya Bhattacharya, Professor of Reproductive Medicine in Aberdeen, who led the study, said that it was difficult to estimate how many women currently used IUI or clomifene citrate treatments, but added that it must be "hundreds of thousands".

NICE endorses the use of up to six free cycles of IUI without ovarian stimulation in couples with unexplained infertility. Thousands of couples are being denied the three free cycles of IVF recommended by NICE as an advanced treatment, largely because of the expense. Figures from the Department of Health showed in June that nine out of 151 primary care trusts in England provided three cycles of IVF, leaving many patients to pay up to $4,000 per cycle for private treatment.

NICE said that the fertility guidance published in 2004 set "clear standards by outlining which types of treatment offer couples the best chance of conceiving, based on the best available evidence from around the world".

Source. Another account of the above findings here.

Researchers Say Antibiotic From Maggots May Kill MRSA

British researchers said Tuesday they've developed an antibiotic from maggots that can be used to fight different kinds of bacteria including certain strains of deadly methicillin-resistant Staphylococcus aureus. The team from Swansea University in south Wales has developed a drug called Seraticin, which is made from the secretions of green bottle fly larvae, Agence France-Presse reported. The researchers are hoping to turn the antibiotic into a drug that can be injected, swallowed as a pill or used as an ointment.

More than 90,000 Americans get MRSA infections each year, according to a study released by the government last October. Medical and government experts worry annual deaths from the drug-resistant "superbug" may soon exceed deaths from AIDS.

MRSA bacteria can be carried by healthy people, living on their skin or in their noses. Most infections occur in hospitals. However, in recent years, the bug has invaded schools, locker rooms and fitness centers.


Scottish government hospital faces criminal charges over 18 superbug deaths

Sad that patients have to die before negligence is noted

Criminal charges could be lodged over "appalling and completely unacceptable" conditions at a hospital where there were 18 deaths linked to Clostridium difficile after a damning independent report was passed to the Procurator Fiscal, the public prosecutor in Scotland. The report into infection control at the Vale of Leven hospital, Dunbartonshire, ordered by the Scottish government and published yesterday, describes inadequate facilities, poor practice and lack of leadership. Fifty-five patients contracted C.difficile at the hospital between last December and June and the bug was recorded as the underlying or contributory cause of death in 18 cases.

The hospital had insufficient handwashing facilities or single rooms, beds were too close together, patients were transferred frequently between wards and the building was rundown. The report also found a lack of leadership and supervision with regard to infection control, and a lack of clarity of roles and responsibilities. It noted that the hospital, which had been under threat of closure for ten years, had a lower priority than others in implementation of policies, surveillance systems and staff development.

Cairns Smith, Professor of Public Health at Aberdeen University, led the independent review team that visited the hospital five times last month and, on one occasion, walked round the wards affected by the outbreak.

Nicola Sturgeon, the Health Minister at Holyrood, said that she had passed the report to the Lord Advocate, who had in turn asked the area Procurator Fiscal for Argyll and Clyde to consider any further action.

Ms Sturgeon said: "Let me be absolutely clear that the picture painted by the review team report is appalling and completely unacceptable. The absence of clear lines of professional responsibility has fostered an environment where there was an inadequate management of a cluster of cases at ward level, or awareness at higher levels. There were also inadequacies and inconsistencies in advice to relatives and in management of patients."

Ms Sturgeon said that she had apologised to families of the victims when she met them yesterday morning and that the health board at NHS Greater Glasgow and Clyde owed them "a direct and unconditional apology for the serious failings on its part". The minister demanded "a clear and unequivocal commitment" to the future of the Vale of Leven hospital and the sustainability of its services. Ms Sturgeon pointed to a "history of neglect" at the hospital. The debate must no longer be about what services were to be withdrawn, she said, but about how the board could create a "modern, fit-for-purpose hospital".

A report from Health Protection Scotland yesterday into levels of C.difficile across the country from last December to June found that there were 3,174 cases, of which 285 patients died with the bacterium an underlying cause or a contributory factor. There were no clusters or outbreaks that had not been identified or reported.

Tom Divers, chief executive of Greater Glasgow and Clyde Health Board, apologised to patients and families. He said: "I recognise the concerns of relatives of patients that they were not properly informed every step of the way of the infection and how to help protect themselves and others from the risk of infection." Mr Divers said that he had ordered immediate improvements to, among other things, hand-washing facilities and bed spacing. A system of infection surveillance across all hospitals had been introduced. "As a result of today's recommendations we will take forward further actions to reinforce leadership, accountability and empowerment both at the ward and hospital level and ensure clear lines of communication and responsibility to the board's medical and nurse directors," he said.

"The uncertainty over the future of this local hospital has undoubtedly been a factor in the lack of major modernisation investments. I can give a commitment that this board will bring forward proposals in August and September that will set out a clear vision for the future of the site."

Syed Ahmed, Consultant in Public Health Medicine at NHS Greater Glasgow and Clyde, said: "The Vale of Leven certainly had more cases of C.difficile than one would expect during the first six months of 2008. Sadly, C.difficile is a germ that is in the community and there will always be sick and vulnerable patients, especially among the elderly, who will develop C.difficile-associated diseases."

Richard Simpson, the Labour public health spokesman, and Jackie Baillie, the local Labour MSP, called for a public inquiry into the deaths. They were joined by Ross Finnie, the Scottish Liberal Democrat health spokesman, while Jackson Carlaw, of the Scottish Conservatives, said that NHS Greater Glasgow and Clyde could not avoid responsibility for the "appalling" loss of life.


Guardian Scientist (and leftist activist) Watson Predicts 4C Rise

Today's headline grabber is part-time scientist, part-time Obama and leftwing activist, Professor Robert Watson. Watson's latest prediction, in a long line of alarmist climate statements, is that the world is set for a four degree C rise in temperatures unless the world listens to him and stops that very nasty carbon emitting business.

Now you might think that yet another doom and gloom prediction from any 'scientific' source would elicit a yawn from most people - not least given the latest cycle of temperature rise ended 10 years ago and that global temperatures are already dropping and set to drop further. Not so the climate alarmist's intrepid flag-waver, The Guardian, which broke today's scary story. Bravely sidestepping the facts and evidence once again it has given a scaremongering platform designed to set the mass media sheep running - not to mention spiking sales. But why Robert Watson?

Well Watson is no ordinary scientist. He makes a living from climate alarmism not only in his taxpayer-funded 'laboratory' but also, in the cause of leftwing politics in the US and UK. The Guardian describes him as a 'chief advisor to the UK government'. Prior to that, of course, he was a senior advisor to Bill Clinton's administration, was a would-be chairman of the alarmist IPCC (till the Vast-Rightwing Conspiracy 'conspired' to unseat him) - who now spends his off-duty hours writing op-eds to get that Obarmy chap elected. Spot the politics here? Are we talking 'fair and balanced'?

Well Watson likes to do more than talk science in his op-eds. Take the one he wrote in May for the South Florida Sun-Sentinel papers in May in which he attempted to re-write history. In his 'politically neutral piece 'Obama Needs Support of Jewish Voters' Watson claimed that Harry Truman was not, as history has it, a blatant anti-semite at all, but was, in fact, sensitive to the "plight of the Jews". As this outraged Jewish reader noted, Truman was in fact an antisemite. And Truman's autobiography makes it perfectly clear that Truman "...was proud of the fact that not one Jew had ever set foot into the homes he shared with his wife."

Good to know The Guardian has maintained its usual high standard of journalistic integrity via such an a-political, 'scientific' source. But wait! Watson ... The Guardian ... Bill Clinton ... Obarmy ... scaremongering for a living ... re-writing anti-semitic history ... could it all just be a Vast Leftwing Conspiracy? Perhaps I'll write a letter to The Guardian ...


Britain: Suddenly being green is not cool any more

Julie Burchill can't stand them. According to her new book, Not in my Name: A Compendium of Modern Hypocrisy, she thinks all environmentalists are po-faced, unsexy, public school alumni who drivel on about the end of the world because they don't want the working classes to have any fun, go on foreign holidays or buy cheap clothes.

Michael O'Leary, the chief executive of Ryanair, agrees. In an interview with Rachel Sylvester and me, he told us that the "nutbag ecologists" are the overindulged rich who have nothing better to do with their lives than talk about hot air and beans.

So the salad days are over; it's the end of the greens. Where only a year ago the smart new eco-warriors were revered, wormeries and unbleached cashmere jeans are now seen as a middle-class indulgence. But the problem for the green lobby isn't that it has been overrun by "toffs": it's the chilly economic climate that has frozen the shoots of environmentalism. Espousing the green life, with its misshapen vegetables and non-disposable nappies, is increasingly being seen as a luxury by everyone.

Only a year ago, according to MORI, 15 per cent of those polled put the environment in their top three concerns. That figure has dropped by a third to 10 per cent this month. Now that people are fighting for their own survival rather than their grandchildren's, they put crime, the economy and rising prices at the top of their list.

According to Andrew Cooper, director of the research company, Populus: "There is a direct correlation between how people perceive the economy and the importance they place on the environment. When times are tough people resent paying more to salve their conscience." This means that fewer people are now buying organic chickens from smart supermarkets when they can pay œ3.99 at Lidl. With all food prices rising, the organic market is being credit-crunched. Demand for it grew by 70 per cent from 2002 to 2007; now it has stalled, according to the consultancy Organic Monitor. The vast new organic Whole Foods Store on Kensington High Street in London is so quiet you can hear the cheese breathe in the specially designed glass room. Meanwhile the demand for takeaway pizzas and McDonald's has risen as people find the cheapest way to eat.

When David Cameron became leader of the Conservative Party he said that green issues were at the top of his agenda. His slogan for the local elections last year was "Vote Blue, Go Green". But in the past few months he has realised that voters have lost the appetite for their greens. He has only given one environmental speech since Christmas. Once he used to talk about putting a $6,000 windmill on top of his house. Now the message is not about conserving the planet but preserving his bank balance. He wears catalogue clothes, grows his own vegetables and holidays barefoot in Britain because it is less extravagant, not because he is trying to reduce his global footprint.

In fact, when the Tory leader's bicycle was stolen a week ago, the message of the story was not how green he was for riding his bike, but how broken our society has become when a politician finds his bike nicked from under his nose.

Boris Johnson was the first to realise that the tolerance for green taxes may have peaked. When he became Mayor of London, he dropped plans to charge a $50 congestion fee on gas-guzzling cars.

The Tories have quietly been reviewing many of their green policies. A range of measures designed to penalise motoring and other polluting activities has been put on hold in case they alienate families struggling to pay their bills. A proposal to tax the highest emitting cars up to œ500 more than the greenest vehicles has been quietly shelved, as has the plan to raise taxes on short-haul flights. Instead George Osborne, the Shadow Chancellor, has promised to cut tax on fuel when oil prices rise.

Gordon Brown has also stopped discussing his solar panels and compost heap in Scotland and is trying to dissociate himself from local council rubbish taxes - even though they have been driven by central government plans to put up landfill charges.

Both parties are looking at ways of rewarding people for being green rather than penalising them for throwing out their yoghurt pots with their teabags. Mr Osborne, in a speech last month, admitted: "When people are feeling the pinch, we need to make it pay to go green. Instead of being fined for not recycling, households should be paid for recycling."

When Barack Obama first decided to run for the presidency, he embraced the green cause. Al Gore's film, An Inconvenient Truth, about global warming had just become the biggest grossing documentary in history and Mr Gore had won the Nobel prize. But recently Mr Obama has been talking more about thrift than trees. Instead of showing off his recycling skills, he explains that his children don't receive Christmas or birthday presents.

It's not just the economic downturn that has harmed the green order. People have become wary of environmental causes that can turn out to do more harm than good. They don't want wind turbines marching across Britain's moors when nuclear power stations can do more to reduce greenhouse gas emissions. They worry that washing and bleaching all those non-disposable nappies may be damaging the ozone layer, that the massive incentives for biofuels have distorted the world food market, and that green taxes are actually stealth taxes.

But paradoxically, just as Britain is turning its back on the environment, the country is finally becoming greener. Fewer people are moving house so they are buying fewer new white goods such as washing machines and fridges. They may not be queueing up for $18 organic Poilane bread, but for the first time in a decade they are discarding less food. They buy less impulsively and think more carefully before their weekly shop. Children are wearing hand-me-down uniforms rather than new ones made in sweatshops.

Bottled water sales have fallen. Garden centres have reported a 10 per cent rise in the sales of vegetable seeds in the past 12 months. People are saving money by growing their own potatoes and carrots. They are turning off their central heating for a few more months of the year and ditching their second car rather than buying an electric runaround. And instead of carbon-offsetting their holidays, they are simply going on fewer of them. It's the downturn that has made greenery look unappetising - but it may yet prove to do more than anything to save the planet.


Nine passengers on every British Airways jumbo lose their bags: "British Airways loses more bags and operates more delayed planes than any other big airline in Europe, a confidential report seen by The Times has found. On the day that BA launched its first advertising campaign to rescue the reputation of Terminal 5 at Heathrow using the tag line "Terminal 5 is working", it emerged that BA customers were 80 per cent more likely to lose their luggage than average in the first half of 2008. Britain's third largest airline, bmi, also had one of the worst records for lost luggage this year, beaten only by BA in a table of 29 European airlines. Nine passengers travelling on a typical BA jumbo jet flight between January and June found that their bags were missing when they arrived at their destination. The research found that one third of BA's short-haul and medium-haul flights and roughly one third of its long-haul arrivals and departures were at least 15 minutes late this year, well below the European average. According to the Association of European Airlines (AEA), which carried out the study, Tarom Romanian Airlines was the most punctual airline."

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