Antibiotics 'ineffective for coughs'

Antibiotics are ineffective in treating patients with persistent coughs caused by mild chest infections, the Lancet journal reports.

About 2,000 patients across 12 European countries filled in an 'illness' diary.

The study found that the severity and duration of symptoms in patients treated with antibiotics were no different to those given a placebo.

But experts caution that if pneumonia is suspected, antibiotics should still be used due to the disease's severity.

Prof Paul Little from the University of Southampton, who led the research, said: "Using the antibiotic amoxicillin to treat respiratory infections in patients not suspected of having pneumonia is not likely to help and could be harmful.

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"Overuse of antibiotics, dominated by primary care prescribing, particularly when they are ineffective, can lead to the development of resistance and have side effects like diarrhoea, rash and vomiting.

"Our results show that people get better on their own. But given that a small number of patients will benefit from antibiotics the challenge remains to identify these individuals."

Previous research into whether or not antibiotics are beneficial in the treatment of chest infections, where symptoms include shortness of breath, weakness, high fever, coughing and fatigue, have produced conflicting results- particularly in older people where chest infections can lead to further complications.

This study randomly divided patients into two groups - one received the antibiotic and the other was given a placebo, an inert treatment in the form of a sugar pill, three times a day for seven days.

The study found little difference in the severity and duration of symptoms reported between groups. This was also true for older patients - those aged 60 years or over - who made up nearly a third of the study.

And those taking antibiotics were reported to have more side effects including nausea, rash and diarrhoea than those given the placebo.

Drug resistance

Chest infections are one of the most common problems patients go to their GP about.

Dr Nick Hopkinson, a member of the British Lung Foundation, thought the study was helpful back-up when patients ask them for antibiotics.

He said: "Some patients with mild chest infections will ask for a prescription - this study can help GPs suggest it may not be the best thing for them.

"Most mild chest infections will settle by themselves with no need for antibiotics - as they are mainly caused by viruses. Those with mild infections are told to come back if symptoms don't get better.

"This study is encouraging and supports what GPs are already doing."

Overprescribing of antibiotics can lead to bacterial infection resistance.

Dr Michael Moore, from the Royal College of General Practitioners, who also co-authored the study, said: "It is important that GPs are clear when they should and should not prescribe antibiotics to patients to reduce the emergence of bacterial resistance in the community.

"This study backs the approach taken in the National Institute for Health and Clinical Excellence (NICE) guidelines that patients who present with acute lower respiratory tract infection where pneumonia is not suspected can be reassured by their GP that they will recover without antibiotics and that the illness is likely to last about three weeks in total whether or not they have a prescription."

The European study, which included Belgium, England, France and Germany, took place between November 2007 and April 2010.

It looked at 2,061 patients who had a persistent cough lasting more than 28 days and where a chest infection, like bronchitis, was suspected.

Those thought to have pneumonia were excluded from the study due to the severity of the disease if not treated promptly.

Participants completed a daily diary for the duration of their illness and rated the the severity of their symptoms including cough, shortness of breath, chest pain, and blocked or runny nose.

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Some foods risk genetic colon cancer

Among people who have a genetic susceptibility to colon cancer, those whose diets are heavy in junk food have an even higher risk, according to a new study.

"These patients have this very high risk because of this (genetic) mutation they have, but it might be that they could reduce the number of (tumors) by having a more healthy lifestyle," said Akke Botma, the lead author of the study.

Botma's study is just the first to find a link between certain foods and a higher colon cancer risk in this group, and it can't prove that the diet is to blame.

All of the people in the study had Lynch syndrome, a genetic disorder that predisposes people to cancer at younger ages and that affects up to one in 660 people.

In Western countries, colorectal and endometrial cancers are the dominant cancers to turn up in people with the syndrome, while in Asia it's mostly stomach cancer, Botma said.

Up to 70 percent of people with Lynch syndrome will develop colon cancer. Among people without Lynch syndrome, such cancers are thought to be influenced by diet, particularly alcohol and red and processed meat, the authors note in their study, published in the journal Cancer.

Botma and her colleagues at Wageningen University in the Netherlands contacted 486 people with Lynch syndrome from a national database of families with inherited risks for cancer.

At the beginning of the study they surveyed the participants about what they ate, and they ranked each person on whether he ate low, medium or high amounts of foods within four dietary categories.

The food groups included one that was dominated by fruits, vegetables and whole grains; another that was high in meat and coffee; a third dietary group that resembled a Mediterranean diet - fish, leafy greens, pasta, sauces and wine; and a fourth group that was heavy on fried snacks, fast food and diet soda.

Botma and her colleagues found that, over 20 months of follow up, 56 of the participants -- or 12 percent -- screened positive for tumors in the colon, a precursor to cancer.

Of the four dietary groupings, only the junk food category showed any link with a different risk for developing colon tumors.

Of the 160 people who scored low on the junk food diet, 17 developed tumors, while 18 out of the 160 people who ate the most junk food developed tumors.

The numbers initially seemed similar, but after taking into account smoking and other risk factors, the researchers determined that those in the high junk food group were twice as likely to develop colon tumors.

HOW TO MANAGE RISKS?

"It's hard to say why" junk food is linked with a greater risk for these tumors, said Dr. Mala Pande, an instructor at the University of Texas MD Anderson Cancer Center in Houston who was not involved in the research.

She said some researchers have suggested that high fat might have something to do with it, but it's impossible to conclude that from this study.

Although the findings are too preliminary to be used in making dietary recommendations to people with Lynch Syndrome, the study was valuable in launching research into the possible role of certain foods on cancer risk, said Christopher Amos, a professor at the Geisel School of Medicine at Dartmouth College.

"People with Lynch Syndrome are at higher risk, and we'd really like to know how to manage their risks better," Amos, who was not part of the study, told Reuters Health.

Certain foods have been shown to be linked with different types of cancer, but many of those studies contradict each other and sow confusion. (Reuters)

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Shortage of critical care

The Paediatric Intensive Care Society and three other medical organisations say all 29 units in the UK are running close to capacity due to a surge in seasonal respiratory illness.

The Department of Health is expected to release additional money to help hospitals with winter pressures.

On Monday there were 10-20 unoccupied beds available.

During the previous week, there were days when virtually all of the beds were full - although doctors stress no child came to any harm as a result.

Services stretched

Medics say paediatric services are working hard to keep up with demand and are under "severe pressure".

Honorary secretary of the Paediatric Intensive Care Society (PICS) Peter Wilson said: "Although all trusts are really stretched we have had zero adverse outcomes, which is good news.

READMORE:http://www.bbc.co.uk/news/health-20755256

Malaria progress threatened

Recent gains in the fight against malaria could be reversed because funding has stalled, the World Health Organization (WHO) has said.

Its latest World Malaria Report says 1.1 million lives were saved in the past decade but that the expansion in funding from 2004-09 halted in 2010-12.

Less than half of the $5.1bn (£3.1bn) needed was spent last year.

The WHO's latest figures - for 2010 - show some 219 million people were infected, with 660,000 people dying.

'Precarious situation'

The WHO said in a statement that the plateau in funds meant "that millions of people living in highly endemic areas continue to lack access to effective malaria prevention, diagnostic testing, and treatment".

Its report said the supply of "life-saving commodities" - such as long-lasting insecticidal nets and indoor spraying programmes - had slowed.

The report said 50 countries were on track to meet targets for cutting malaria cases but that these countries only represented 3% of malaria cases.

Fourteen nations account for an estimated 80% of malaria deaths and Robert Newman, director of the WHO Global Malaria Programme in Geneva, said these high-burden countries were "in a precarious situation and most of them need urgent financial assistance".

Lead report author Richard Cibulskis said: "We need to make sure that we continue the investments in the control measures that we have.

"If we don't do that, malaria will bounce back. As soon as you take bed nets away, malaria will come back. If you stop indoor residual spraying, it will come back, and with a vengeance."

READMORE:http://www.bbc.co.uk/news/health-20760235