What does it tell you that the NHS has a rapid response rat removal team?

ONE of Scotland’s busiest hospitals has had to call in infestation control teams to tackle a plague of rats in its grounds.

Patients at the Victoria Infirmary in Glasgow spotted the vermin, near the Accident and Emergency Department, in Langside Road, and the rats have been seen in various locations around the hospital grounds during the day.

One patient said: “This really should not be happening in modern-day hospitals. It’s a disgrace, more needs to be done to keep hospitals clean.”

A health board spokeswoman said pest controllers were brought in immediately after the rats were discovered.

A spokeswoman for NHS Greater Glasgow and Clyde said: “A rapid response service is in place so that if staff suspect any problems, experts are immediately called in. We also routinely inspect our sites for any pest control issues rather than wait for them to be reported.”

SOURCE. H/t Interested Participant

Dozens have died through incompetent out-of-hours cover for their GPs

At 2am on June 15 last year, Lee Kerrigan took his six-year-old son Ethan to hospital. The little boy was suffering from stomach pains and vomiting, but there were no doctors on duty in St Austell, Cornwall, and Mr Kerrigan was told to call the out-of-hours medical service.

He rang from the hospital car park and spoke to a nurse, who said to give Ethan painkillers and to take him to see the GP the next day. She’d failed to recognise the warning signs of a burst appendix.

By the time Ethan saw the GP at 2.30pm the following day, he was seriously ill with septicaemia. He was taken to hospital, where he died.

Dean Beresford, a 44-year-old from Gainsborough, in Lincolnshire, contacted an out-of-hours service after developing chest pains and difficulty breathing.

There followed a series of medical mix-ups that began when a phone operator failed to note on his records that Mr Beresford was suffering chest pains. His call was passed to a nurse, who should have called an ambulance ‘within a minute’ of him describing his symptoms, an inquest later heard.

Instead, the nurse told him to wait for an out-of-hours GP to call him back. This GP then told Mr Beresford to go to an out-of-hours clinic, where another doctor diagnosed a bad cough and prescribed antibiotics.

Mr Beresford collapsed and died at work two weeks later, on August 11, 2010, with a ruptured heart.

Ethan and Mr Beresford were sorely failed by out-of-hours services (the GP care provided at night, weekends and on public holidays).

When Jeffrey Wingrove, 48, suffered severe vomiting and crippling headaches, his wife Isabelle called the out-of-hours service three times from their home in Braintree, Essex. A GP from Primecare (a commercial company) diagnosed vertigo over the phone and sent a prescription for anti-sickness medication to a local pharmacy. Shortly afterwards, Mr Wingrove suffered a brain haemorrhage and died later in hospital.

Five years after his death, the GMC ruled the doctor had ‘failed to elicit an adequate history; to consider all the symptoms and other information reported to her and refused to arrange a home visit when the situation clearly warranted one’.

In February, an out-of-hours GP failed to spot that five-year-old Kelsey Smart was suffering from a potentially fatal, but treatable, bacterial disease and sent her home. When the little girl from Bristol finally made it to hospital, it was too late to save her from meningococcal meningitis.

When father-of-two Craig Davidson injured his neck playing football, an out-of-hours doctor diagnosed a panic attack and prescribed tranquillisers. A few hours after the doctor’s visit, Craig, from Dundee, was found dead on the kitchen floor by his mother and son. He’d died from a ruptured spleen.

Charity worker Gary Lovett, 20, from Southampton, suffered vomiting, fever and chest pains a few days before Christmas 2010. Despite repeated calls from his parents to NHS Direct and the out-of-hours service, he was told to take over-the-counter flu treatment and was prescribed antibiotics by the out-of-hours doctors and sent home. He died on Boxing Day.

The problem with out-of-hours care is not simply this ‘small number of disastrous incidents’, as the Primary Care Foundation put it recently. For even when patients aren’t experiencing ‘disastrous incidents’, many are deeply unhappy with the GP cover they receive.

According to a recent survey for the Department of Health, 14 per cent of patients rated their out-of-hours care as poor, while 16 per cent thought it was ‘neither good nor poor’, and 31 per cent said they had waited too long for help.

Until recently, your own GP would be the one who would respond to a call for help in the middle of the night.

‘The service as it used to run was working well from the perspective of patients,’ says Michael Watson, of the Patients Association. ‘We’ve changed it because GPs said they didn’t want to run it that way, but what we have changed to clearly isn’t working from the perspective of the patients.’

He’s referring to the fact that in 2004, GPs negotiated a contract that allowed them to opt out of out-of-hours care.

Into the breach stepped GP co-operatives — in which doctors banded together to share the burden of care — and, increasingly, commercial companies.

In 2010, there were 23 commercial companies running 227 surgeries and health centres around the country.

What kind of care does a commercial company provide? It is perhaps telling that when it comes to how patients rate the care they receive, only one commercial provider appears in the top 30 in a recent survey by the Primary Care Foundation (an independent body that assesses health care).

At the other end of the table, commercial providers occupy three of the five bottom slots.

One of the major commercial providers is Serco — an international company that also carries out school inspections for Ofsted, as well as operating four prisons, two immigration centres and Boris Johnson’s cycle hire scheme for Transport for London.

Serco ran the out-of-hours service involved in Ethan Kerrigan’s case.

It is also under investigation by the Care Quality Commission over whistle-blower allegations that its out-of-hours GP cover in Cornwall has unsafe staffing levels, and that it’s been massaging figures to ensure it met performance targets, including waiting times.

The NHS is facing increasing demands to save money and the fear is that more out-of-hours services will be taken over by big companies who can under-cut GP co-operatives.

Staffing is a key area of concern, both for co-operatives and commercial companies. Many out-of-hours services are struggling to find enough doctors to provide safe and consistent cover.

An investigation earlier this year by Pulse, the GP magazine, found that in some parts of the country, up to a quarter of GP out-of-hours posts were going unfilled.

Ironically, the most severe shortages were in the east of England where, in the wake of the Ubani case, only local doctors are allowed to work in the system.

The Care Quality Commission, which registers all out-of-hours services, says there are 115 operated by 47 providers, but it was unable to say how many of those were commercial operations — a factor ‘not terribly important to the regulatory process’, as it told the Mail.

The hope is that some of the NHS reforms — such as inspections by the Care Quality Commission — mean that ‘poor out-of-hours GPs will perhaps get picked up in a way they haven’t before’, says Michael Watson.

Joyce Robins, co-director of Patient Concern, is more cynical about the changes. ‘I have yet to hear what the benefit is for patients and I’m not sure there is any,’ she says.

‘And we haven’t seen the back of it, by any means. I’m on the West Sussex coast, where there’s a very elderly population.

‘If you phone the out-of-hours service you might get a nurse, you might get a paramedic — if you get anybody — or you might get a doctor who has come from abroad and whose language you do not speak.

‘I have a neighbour who was very ill recently. Someone arrived and she couldn’t understand a word he said….. it’s very, very dangerous.’

Indeed, four years after Mr Gray’s death, the proposal to protect patients by placing responsibility for doctors’ language skills on named ‘responsible officers’ has yet to be implemented.

‘Out-of-hours care is so patchy,’ says Joyce Robins. ‘We do get reports from people who are having excellent service, but then we get reports from others who are really left without cover.

‘We call it a National Health Service, but it’s nothing of the sort. ‘There seems to be no overall hand on it and that seems to be what is wrong with the whole service, whether you talk about provision of drugs, waiting times or out-of-hours service. ‘It just depends where you live — it’s pot luck.’


Mother, 37, left infertile after doctors misread TWO smear tests leaving her prey to cervical cancer

A mother who developed cervical cancer and was left infertile after her smear test results were misread twice has been awarded £50,000 compensation.

Claire Millward, 37, had two smear tests where pre-cancerous cells were present. However, she wasn’t called for follow-up appointments on either occasion.

Mrs Millward continued for the next four years thinking she was healthy but was horrified to be diagnosed with cervical cancer in 2009. By this stage it was too late to save her womb and she had to have a radical hysterectomy.

The life-saving surgery was a success, but left the mother-of-one unable to have any more children.

Northampton General Hospital has now admitted that the smear tests were not read properly and an independent medical expert said Claire’s cancer could have been prevented.

Claire, a letting agent, said: ‘If they had spotted the cancer earlier I would not have lost my womb and could have more children now. ‘We wanted a big family and we were actually trying for another child when the cancer came.

‘Basically the negligence of some people has had a dramatic effect on my life. I want to ensure that no-one else has to go through this.’

Mrs Millward, who lives with her husband Carl, 43, and son Jamie, eight, in Northampton, had two smear tests at Northampton General Hospital in 2003 and 2005.

The first test showed borderline changes, the second should have been read as abnormal and both should have resulted in follow-up appointments.

Claire had another smear test in 2008 that again came back negative, but she felt something was wrong. She had been told by the hospital she couldn’t have another until September 2009, but got one at her doctors in February.

Luckily doctors caught her cervical cancer in time to save her life, but Claire had to endure an emergency radical hysterectomy, including lymph node removal, in March 2009 leaving her infertile.

She said: ‘I burst into tears when I found out I had cancer. ‘But the most scary thought ever is what could have happened if I had not asked for another test. I don’t know what made me push for a test so much, but I am so glad I did. ‘The independent medical expert said if I had waited until September to have treatement I would have been dead as the tumours were growing.’

An independent cytopathologist who reviewed Claire’s case said if the abnormal cells had been picked up on her 2003 or 2005 scans she could have been treated with a cone biopsy and she would have kept her womb.

Claire’s solicitor Neil Clayton, from Harvey Ingram, said: ‘Claire’s 2003 smear showed borderline changes and should have resulted in a colposcopy referral for a detailed investigation.

‘Her 2005 smear result was abnormal, again showing glandular neoplasia, and Claire should have had an urgent colposcopy referal. ‘Our independent cytopathologist said they should have done a cone biopsy to remove the abnormal, pre-cancerous, cells if the tests had been read correctly.

‘If they had read the results right in first place she would not have gone on to develop the cancer and avoided the hysterectomy.’ He added: ‘The lesson for hospitals is to be very careful to keep on top of results and ensure there are regular audits.’

Northampton General Hospital have now sent Claire a letter of apology and reviewed its policy.

A hospital spokesman said: ‘We accept that, regrettably, those smears were incorrectly reported and that this may have contributed to a delayed diagnosis of glandular neoplasia (abnormalities of glandular cells).

‘We are truly sorry for those errors. We carry out thousands of cervical smear tests annually, and we would like to reassure all our patients that this is a most exceptional case.

‘We are determined to learn from it and we have reviewed our procedures to ensure there is no recurrence of the failings experienced by Mrs Millward.’ [The usual bunk}


Now it’s a U-turn on student visas: British PM wants to relax rules preventing university migrants

David Cameron is preparing to make a U-turn over foreign students after pressure from Liberal Democrat MPs.

Currently, non-EU students – arriving at a rate of 225,000 a year – are included in immigration statistics to reflect the way they add hugely to the population.

Ministers, who have pledged to reduce net migration to the ‘tens of thousands’, have been working on plans to slash dramatically the number of student visas given out.  Research shows that up to a quarter of them are not ‘genuine’ students.

But Lib Dem Business Secretary Vince Cable, supported by universities and some figures at No 10, instead wants students to be removed from the immigration figures altogether.

This would mean there was no longer pressure on the Government to get a grip on non-EU student visas, which have been subject to rampant abuse in recent years.

The Home Office has been resisting the idea, which immigration minister Damian Green called ‘absurd’.

But in a move which will enrage Tory backbenchers, it emerged last night that Mr Cameron is considering siding with Mr Cable, who says foreign students are worth billions to the economy.

There is a powerful faction inside Downing Street, understood to include Cabinet Secretary Sir Jeremy Heywood, urging the Prime Minister to head in this direction.

A source at No. 10 reportedly said Mr Cameron ‘understands’ their arguments and is ‘definitely considering a change of policy’.

The move, which follows U-turns on the Budget and others including petrol tax and public sector pay, would provoke a fierce response from campaign groups and backbench MPs.

The Migrationwatch think-tank says removing student visas from the calculation would ‘destroy public confidence in the Government’s immigration policy’.

Instead of bringing immigration under control, all ministers would be doing is reclassifying what constitutes a migrant.

The row comes after Home Office research showed that as many as one in four foreign students allowed into Britain may not be genuine.

Interviews with non-EU applicants revealed more than 25 per cent were not credible, but immigration officials were forced to let them in regardless.

The highest number of bogus entrants come from the Indian sub-continent, Burma, the Philippines and Nigeria.

Staff were left hamstrung three years ago when Labour stripped them of powers to block suspected bogus students.  Home Secretary Theresa May will today restore that discretion amid fears the move has created a huge loophole in border controls.

A Migrationwatch report found that foreign students are adding 75,000 to the population every year by not going home at the end of their courses. Some 25,000 of these remain here illegally.

The remainder either take jobs or are given permission to settle down with a partner or undertake further studies.

Last night, a Border Force spokesman said: ‘We are clear that overseas students should remain part of the net migration figures.’


British Christians sue Eric Pickles for £25K after block on conference promoting heterosexual marriage

The organisers of a major conference defending traditional marriage are suing the Government after they were barred from an official building because they allegedly breached ‘diversity’ policies.

The conference, whose high-profile speakers included David Cameron’s ‘Big Society’ guru Phillip Blond, was cancelled at the last minute by  the Government-owned Queen Elizabeth II Conference Centre in Central London after organisers were told it was ‘inappropriate’.

Communities Secretary Eric Pickles is now facing claims for £25,000 for breach of contract and religious discrimination, according to legal papers seen by The Mail on Sunday.

The legal action may prove particularly embarrassing for Mr Pickles, whose department is responsible for the centre, as he has robustly defended the rights of Christians to express their faith in public.

The conference promoting heterosexual marriage was organised by the campaign group Christian Concern along with a non-religious American organisation called the World Congress of Families (WCF), whose supporters include former President George Bush.

Entitled One Man, One Woman – Making The Case For Marriage, For The Good Of Society, the event, a response to Government plans to introduce gay marriage, had a line-up of speakers including Ben Harris-Quinney, chairman of the Conservative Party’s oldest think-tank the Bow Group, and the commentator and former Catholic Herald editor Cristina Odone.

The conference had been moved to the Queen Elizabeth II Centre near Parliament after solicitors’ representative body The Law Society, which had been due to host the conference at another venue, said it contravened the organisation’s ‘ethos’.

However, on May 22, the day before the rearranged conference was due to take place, the centre’s chief executive, Ernest Vincent, told Christian Concern he was cancelling the event.

According to the legal documents, he said it was ‘inappropriate’ and when pressed added that certain comments on the WCF website were contrary to the centre’s diversity policies. The website describes marriage between men and women as the ‘sole moral context for natural sexual union’.

A spokesman for the Department for Communities and Local Government said: ‘The department has had absolutely no role in the cancellation of the event and this is ultimately a matter for the management of the QE2.’ Mr Vincent said:  ‘We don’t as a matter of policy comment on  clients’ files.’

Christian Concern founder Andrea Williams said the centre had earlier hosted a conference by  gay-rights organisation Stonewall. She said: ‘It would seem that the centre does not extend the same hospitality to Christian groups.’


Aggressive cyclists virtually above the law in Britain

All of us sometimes read newspaper stories that make our blood boil. I encountered one of these yesterday morning.

It concerned a cyclist named Andrej Schipka. He has been convicted of knocking over and severely injuring a leading solicitor in London last July after ignoring a red light and sending his victim spinning into the road.

As a result, Clive Hyer suffered brain damage and is unlikely ever to be able to work properly again. His witness statement claimed that he is only 40 per cent of the person he was before the accident.
CCTV footage showed Schipka skipping a red light. According to witnesses, he shouted ‘Oi, move’, as he saw Mr Hyer step into the road. He went over the handlebars but neither he nor his bike was damaged. Mr Hyer was in a coma for three days.
Two-wheeled rage: The number of cyclists skipping red lights, and screaming and swearing at pedestrians, appears to have reached record levels

Two-wheeled rage: The number of cyclists skipping red lights, and screaming and swearing at pedestrians, appears to have reached record levels

A pretty serious offence? Most of us would think so. A man’s life has been half ruined, and that of his family severely affected. And yet Schipka — who’d had the brass-neck to deny he had skipped the light, and disputed that he had not given due consideration to pedestrians — was fined a mere £850 for cycling carelessly. He was also required to pay £930 costs and a £15 surcharge.

Schipka, who is a German citizen, will almost certainly face a civil action at the end of which he could be required to pay damages, though whether he would be able to do so is not clear. What is certain is that the criminal law has applied a penalty that is ludicrously light in view of the seriousness of the offence.
Soft justice? The maximum penalty for careless cycling is a £1,000 fine, while it is £2,500 for dangerous cycling

Soft justice? The maximum penalty for careless cycling is a £1,000 fine, while it is £2,500 for dangerous cycling

The maximum penalty for careless cycling is a £1,000 fine. For dangerous cycling it is £2,500. By contrast, someone convicted of careless driving faces a maximum fine of £2,500 and possible disqualification, whereas a person found guilty of dangerous driving is automatically disqualified and can be sent to prison for up to two years. Causing death by dangerous driving can carry a long jail sentence.

Already I can feel the bikers among you stirring uneasily. You will point out that very many more car, lorry and bus drivers kill cyclists than cyclists kill pedestrians or anyone else. That, of course, is perfectly true.

If any driver causes the injury or death of a cyclist through careless or dangerous driving, I am entirely in favour of the full force of the law being applied. I am not in any sense anti-cyclist or pro-driver.

My point is simply that the law should be consistent, and that cyc-lists should not imagine that they are exempt from it. And yet many of them appear to. In the city where I live, Oxford, cyclists almost uniformly ride through red lights just as Mr Schipka did, not infrequently shouting something far worse than ‘Oi, move’ if you get in their way.

Some of them are youths or students who might be expected to be uncouth. Others are sturdy matrons or gentlemen of advanced years who in other circumstances would not dream of breaking the law. What is so extraordinary is that if you politely point out their infringement, normally peaceable souls are liable to yell obscenities at you, contorting their habitually placid faces with hate-filled rants.

Rather as the internet can turn usually polite people into howling monsters, posting vile or threatening comments or blogs, so bicycles can have a similarly transformative effect on the mild-mannered and law-abiding. It’s bizarre.

As most of us know, Lycra-clad young men and women on racing bikes tend to be the most prone to outbursts of aggression and to strings of expletives. Woe betide if you get in the way of one of these tartars after they have jumped a red light!
Simple: While we should be encouraging cycling, and raising awareness of general road safety, cyclists must adhere to the rules of the road like everyone else

Simple: While we should be encouraging cycling, and raising awareness of general road safety, cyclists must adhere to the rules of the road like everyone else

Needless to say, the police are generally useless in such circumstances. They are remarkably indulgent towards cyclists who don’t have lights on their bikes at night, endangering not only themselves but others. They tend to smile amiably at cyclists who go the wrong way down a one-way street. Riding on pavements, which is supposedly illegal, is apparently fine and dandy.

And yet not long ago, when I was momentarily and most unusually driving without a seatbelt — putting no one other than myself at risk — a young policeman stopped me and delivered a most unfriendly lecture. You wouldn’t catch him doing the same to one of the light-jumping Lycra brigade.

The fascinating question is why so many cyclists think it all right to break the law, and why some of them — a minority, I’m sure — resort so easily to snarling and swearing. Maybe they have a sense of victimhood, in some cases bordering on paranoia, because the drivers of vehicles sometimes cut them up or do not know they are there. Fear may make them aggressive.

But this is a tentative explanation, not a justification. Cyclists are obviously vul-nerable to vehicles, and we drivers should do our utmost to be aware of them. Much more should be done to increase their safety. But we bikers — I occasionally cycle, too — should remember that bicycles can also cause serious injury. We shouldn’t break the law.

And it seems odd to me that the criminal law should regard careless cycling when it causes injury as a less serious offence than careless driving. In some European countries, such as Holland and Belgium, there is a presumption of innocence in favour of cyclists in an accident involving vehicles, which pro-cycling lobbyists would like to apply here.

We haven’t got there yet, and I don’t think that we should. But we appear already to have a criminal law that regards a dangerous offence committed with a bicycle as automatically less serious than an offence with a similar outcome committed with a larger vehicle. That doesn’t seem just.

Nor is it fair or reasonable for a driver convicted of careless or dangerous driving to be disqualified while a cyclist guilty of the same offence is allowed to carry on as though nothing has happened.

Andrej Schipka did not merely receive a derisory fine. He is also free to continue riding his bike without any threat of even a short-lived ban.

Clive Hyer’s terrible misfortune should remind us that cyclists, like everyone else, are subject to the law. Such accidents may be relatively uncommon, but they are not unheard of. A former colleague of mine was very seriously injured after being struck by a cyclist.

Pedestrians have rights, too. Cyclists should stop caterwauling and threatening. By all means let’s encourage more bicycling, and do more to protect cyclists from menacing vehicles and bad drivers.

But at the end of it all, cyclists should remember that they have no more right than anyone else to swear and to curse, and they are not above the law.


Priced out of a degree: 15,000 young Brits give up on university dream as £9,000 fees hammer middle class

Thousands of middle-class pupils have been put off going to university by the increase in tuition fees to as much as £9,000 a year.  Demand for places this autumn has fallen most sharply among sixth-formers from middle and higher-income homes following the near-trebling of fees from £3,375.

Most fail to qualify for grants, bursaries or fee discounts and must take out the maximum available loan to cover fees and living costs.

Figures published yesterday by the Universities and Colleges Admissions Service reveal how 15,000 18-year-olds in England have been deterred by higher tuition fees.

The figures suggest they are deciding in greater numbers to bypass university and use their A-level results to look for jobs to avoid building up predicted £40,000 debts.

The number of UK university applicants has fallen 8.9 per cent – or 50,339 – following news that universities will impose higher charges this autumn. In England, with fees considerably higher than in other home nations, demand plunged 10 per cent.

Older students have deserted higher education in greatest numbers, with lesser falls among 18-year-old school leavers.

Analysis accompanying the figures reveals that the percentage of 18-year-olds applying from the poorest fifth of families in England has dipped slightly, from 19 per cent in 2011 to 18.8 per cent. These students’ families earn up to £15,000 before tax.

Among households earning up to £30,000, the proportion of applicants dropped 0.7 points to 26.5 per cent.

Demand dipped more sharply among  middle-income families earning between £30,000 and £50,000, falling 1.1 points to 32.8 per cent.

Among higher-earners, with household incomes of £50,000 to £75,000, the proportion of applicants dropped 2.1 points to 40.7 per cent.

And among the richest fifth of families in England, earning at least £75,000, demand slid 2.6 points to 53.7 per cent.

‘The application rates for young people from all backgrounds have fallen in 2012 with the largest declines for those from the most advantaged backgrounds,’ the report said.

Overall, one in 20 18-year-olds in England who would have been expected to apply to university this year has failed to do so.  In contrast, in the other UK nations where fee levels are unchanged on last year, application rates ‘continue on trend’.

The Mail reported yesterday how students from  middle-income families are expected to graduate with the most debt – £43,585 – according to research by the Institute for Fiscal Studies. They are also less likely to be eligible for grants after the qualifying income level was reduced from £50,695 to £42,600.

UCAS chief executive Mary Curnock Cook said: ‘This in-depth analysis of the 2012 applications data shows that, although there has been a reduction in application rates where tuition fees have increased, there has not been a disproportionate effect on more disadvantaged groups.’

The UCAS analysis presents tentative evidence that sixth-formers are more likely to apply to the most prestigious universities following the reforms, and choose courses which bring higher estimated graduate salaries. Many arts courses saw a decline in popularity while the sciences held up well.

Universities Minister David Willetts said: ‘The proportion of English school leavers applying to university is the second highest on record and people are still applying. This will still be a competitive year as people continue to understand that university remains a good long-term investment for their future.’


Parched and tired all the time? You could have ‘dry body’ syndrome

Good to hear that there are potential medications for it on the way

Dry eyes are a problem for many of us at some point or another.  But when Fiona Sewell started waking each day with her eyelids sticking together and the whites of her eyes a worrying shade of red, she knew something more serious was going on.

‘My eyes constantly felt gritty and uncomfortable — I had poor vision and applying make-up was an ordeal,’ says Fiona, 50, a part-time student from Rugby.  ‘Eye drops just seemed to make them worse.  ‘I was clueless as to what could be causing it.’

She developed other symptoms including a dry mouth, which made swallowing difficult, constipation, abdominal pain and fatigue.

‘First thing in the morning, my mouth would be so dry that when I tried eating I would end up retching and choking,’ she says.

‘The fatigue could be incredible — sometimes I had to stop what I was doing to lie down, and then I’d have the deepest sleep.’

It took eight years before Fiona was finally diagnosed with Sjögren’s syndrome, an auto-immune condition thought to affect up to half a million people in Britain.

The American tennis player Venus Williams recently revealed she has Sjögren’s, and commentators have suggested her shock early departure from the ladies singles at Wimbledon this year was down to fatigue from the condition (though she did manage to win the doubles with her sister Serena).

Sjögren’s occurs when white blood cells attack the body’s secretory glands, including the tear and saliva glands, causing inflammation and reducing the amount of saliva, tears and fluid produced.

This causes a dry mouth and dry eyes, as well as constipation, vaginal dryness, joint pain and fatigue.

‘For reasons no one knows, the immune system malfunctions and causes problems in the glands that keep things moist,’ says Dr Simon Bowman, a rheumatologist at University Hospital Birmingham and Spire Parkway Hospital.

‘We believe B-cells (one of the main types of immune cells) are particularly activated in Sjögren’s, particularly those related to salivary glands.  ‘But this can have an effect anywhere in the body where lubrication is required.’

It can also trigger inflammation in the joints, causing swelling and pain, and the nervous system, causing loss of feeling in the hands and feet.

Like many auto-immune illnesses, it’s a condition that affects more women than men — 20 to 30 for every man — probably because the female hormone oestrogen can interfere with the immune system.

It is most common in those aged 40 to 60, and doctors believe the menopause — when levels of oestrogen begin to fall — may have a role.

Some patients are prescribed Pilocarpine, a drug that treats the symptoms of dryness by stimulating secretion.

However, there’s no specific medication to tackle the cause, says Dr Bowman.  ‘There are quite a few medications that are being used in rheumatoid arthritis and lupus that could be trialled in Sjögren’s, so we’d be keen for the pharmaceutical industry to invest in exploring those options.’

Dr Bowman is leading a £1 million clinical trial on behalf of Arthritis Research UK looking at the drug Rituximab.  This is licensed to treat severe rheumatoid arthritis, and works by attacking B-cells.

The hope is that by easing the immune response in this way the drug could dramatically improve dryness and fatigue in Sjögren’s sufferers.

‘There is good background research to suggest Rituximab is worth looking at,’ says Dr Bowman.  ‘Our earlier pilot study showed that treating patients with a single course of the drug resulted in some improvement in fatigue.  ‘An earlier Dutch study that looked at 30 patients also resulted in improvement in fatigue levels and the dryness symptoms.’

Patients in the new 12-month study will receive two courses of Rituximab or a dummy infusion.  Each course is made up of two infusions given two weeks apart — the courses will be given six months apart.



About jonjayray

I am former member of the Australia-Soviet Friendship Society, former anarcho-capitalist and former member of the British Conservative party. The kneejerk response of the Green/Left to people who challenge them is to say that the challenger is in the pay of "Big Oil", "Big Business", "Big Pharma", "Exxon-Mobil", "The Pioneer Fund" or some other entity that they see, in their childish way, as a boogeyman. So I think it might be useful for me to point out that I have NEVER received one cent from anybody by way of support for what I write. As a retired person, I live entirely on my own investments. I do not work for anybody and I am not beholden to anybody
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