Editor's Choice | This Week in BMJ | Press releases
BMJ No 7107 Volume 315 Press Releases Saturday 30 August 1997 Embargoed: 00.01 Hrs 29 August 1997 UK time
Fluoridation can halve tooth decay in children
Increasing levels of tooth decay in 5 year olds may reflect increasing levels of child poverty, says a paper in this week's BMJ. Fluoridation of water is the best way of reducing the "dental health divide" by improving the dental health of poorer people in Britain, say the authors. They studied the dental records of a random sample of 5 year olds in three areas: Hartlepool (where the water is naturally fluoridated). Newcastle and North Tyneside (artificially fluoridated) and Salford and Trafford (non-fluoridated). The analysis showed an overall 44% reduction in tooth decay in fluoridated areas, which increased to 54% in areas of the greatest socioeconomic deprivation. Hartlepool, where the level of naturally occurring fluoride is slightly higher than in artificially fluoridated areas had even higher levels of decay reduction - 66%, and 74% in the most deprived areas. The more deprived an area, the greater the benefit children derive from fluoridation, conclude the authors.
Contact: Wigan and Bolton Health Authority
Tel: (Wed & Friday)
01942 772 770
The incidence of acute upper gastrointestinal haemorrhage (bleeding from the stomach and duodenum) in the west of Scotland is 67% greater than any previously reported incidence in the UK, says a paper in this week's BMJ. Peptic ulcers are the most common cause of such bleeding, and the incidence of peptic ulceration is higher in Scotland and the north of England than further south,say the authors. A substantial part of this incidence may be attributable to socioeconomic deprivation, they suggest. There is now a recognised association between Helicobacter pylori infection (a causative factor in peptic ulceration), socioeconomic group, and childhood living conditions, and an increased prevalence of Helicobacter pylori has recently been found in the north of England and Scotland. Overall mortality from upper gastrointestinal haemorrhage may increase as the elderly population increases, since both incidence and case fatality rise with age, say the authors. They who call for the targeting of clinical resources towards elderly patients in order to reduce the overall death rate from this condition.
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In an editorial in this week's BMJ, Dr I Ralph Edwards, director of the Uppsala monitoring centre (WHO collaborating centre for International Drug Monitoring) wonders whether progress in finding adverse drug reactions has benefited patients. There is a gap, he says, between the development of pharmacovigilance knowledge and its use in practice. Some drugs are too widely used when there are safer alternatives, and others have been taken off the market when they still have a useful place. "We are some way from satisfactory, open, communication particularly with patients, on benefit and risk in therapeutic choices. The gaze of pharmacovigilance professionals has been preoccupied by gathering complete information and developing a more certain science. We must also be sure that individual patients benefit as much as possible from the information they give us", he concludes. Contact:
Uppsala Monitoring Centre,
Tel: 0046 1865 6060
Hospital pharmacists could make a useful contribution to the Committee on Safety of Medicines (CSM) 'yellow card' scheme for reporting adverse reactions to drugs, says a paper in this weeks BMJ. Until April this year the scheme only registered reports from doctors, dentists and coroners. The authors assessed a pilot scheme involving hospital pharmacists in the north of England, and found a 45% overall increase in the reporting of adverse drug reactions. Reports of serious drug reactions increased by 54%. Reports from hospital pharmacists were comparable with those from hospital medical staff but included significantly more suspected serious reactions, say the authors. "Our results suggest that direct reporting of suspected adverse drug reactions by hospital pharmacists would enhance the yellow card scheme and improve pharmacovigilance within the United Kingdom", they conclude. Professor Michael Rawlins, one of the authors who is chairman of CSM, said "This study has been important in demonstrating the contributions that hospital pharmacists can make in monitoring drug safety. Their reports complement those of hospital doctors and I am confident that the inclusion of hospital pharmacists in the scheme will increase reporting."
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Note for editors:On August 16 the BMJ carried a letter saying that some categories of drugs derived from certain animal products were likely to be banned by the EU. The author mentioned two drugs produced by CP Pharmaceuticals of Wrexham: Hyalase and Hypurin.A letter from CP's sales and marketing director in this week's issue claims that these drugs will continue to be available, since they are not derived from any of the materials to be banned.
Embargoed: 00.01 Hrs 29 August 1997 UK time
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