In brief

BMJ 2015; 350 doi: (Published 28 April 2015) Cite this as: BMJ 2015;350:h2242

European drug agency advises on codeine in children: Codeine should not be used to treat coughs and colds in children under 12 or in children aged 12-18 who have respiratory conditions, the drug regulatory body for the European Union has said. The European Medicines Agency’s Coordination Group for Mutual Recognition and Decentralised Procedures—Human also said that codeine is contraindicated in women during breast feeding and in patients known to be CYP2D6 ultra-rapid metabolisers. The new advice came after a review of codeine that identified 14 cases of codeine intoxication in children related to the treatment of cough and respiratory infection, four of which had a fatal outcome.

College issues criteria for diagnosing infant death: New guidance from the Royal College of Paediatrics and Child Health recommends that the neurological clinical examination used to diagnose death in older children and adults is appropriate for infants aged between 37 weeks’ gestation and 2 months.1 It says that there should be an observation period of at least 24 hours where there is a clinical state of complete unresponsiveness. Previously the college had said that it was “rarely possible” to confidently diagnose death by neurological criteria in a comatose and unresponsive young child. Instead UK doctors waited for the heart to stop to diagnose death in unresponsive infants.

Hinchingbrooke improves but remains in special measures: Hinchingbrooke Health Care NHS Trust has been rated as requiring improvement after its latest inspection by the healthcare regulator in January, after its “inadequate” rating given in September 2014. The trust remains in special measures and continues to be supported by the Trust Development Authority to improve its services. Hinchingbrooke was managed by the private company Circle from February 2012 to the end of March this year, but Circle withdrew from the 10 year contract early, saying that it was not viable.2

New health app guidance aims to protect patients: The Royal College of Physicians has produced a factsheet on using medical apps, to help doctors protect patients.3 The factsheet explains what is and what is not a medical app, what to do if you are using or developing a medical app, and how to report problems with apps. It advises doctors not to use medical apps, including web based apps, that do not have a CE mark and to always exercise professional judgment before relying on information from an app.

Cigar smoking has similar risks to cigarette smoking: People who exclusively smoke cigars increase their risk of all cause mortality, oral cancer, oesophageal cancer, pancreatic cancer, laryngeal cancer, lung cancer, coronary heart disease, and aortic aneurysm, a review of 22 studies has found.4 The risk of death from oral, oesophageal, and lung cancers was found to increase with full inhalation of cigar smoke. Even people who reported not inhaling the cigar smoke had an increased risk of death caused by oral, laryngeal, and oesophageal cancer.

Ecuador is urged to change abortion law: The campaigning group Human Rights Watch has written to Ecuador’s government calling for it to decriminalise abortion in line with recommendations of the United Nations, which says that women should be able to access abortion in cases of rape, incest, and severe fetal impairment. Ecuador allows abortion only when there is a threat to the life or health of a pregnant woman that cannot be averted by other means and in cases of pregnancy resulting from the rape of a woman with a mental disability.


Cite this as: BMJ 2015;350:h2242


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