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Responding to the release on 14 December 2016 of the 2015 Health Survey for England, Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance UK, said:
"We welcome the continuing downward trend in children aged 8-15 being exposed to alcohol.
However, the figures for adults are worrying as they reveal that in 2015, 31% of men and 16% of women in England drank more than the current low risk weekly guideline of 14 units a week spread out across 4-5 days.
Drinking above the low risk guideline places people at increased risk of illnesses like heart disease, liver disease and cancer.
The most recent UK guidelines on low-risk drinking, and the reasons behind them, have simply not been communicated adequately. The government needs to ensure the public are aware of the current drinking guidelines, as well as the harms associated with alcohol. The public have the right to know, so they can make informed choices about their drinking.
The government should communicate the risks in two ways.
Firstly, the government should develop mass media campaigns outlining the risks. These could include TV and radio advertisements, social media campaigns, and messages on public transport.
Second, the government should introduce mandatory labelling of all alcoholic products, containing clear and legible health information about the harms associated with drinking."
HCV Action has produced a new resource, aimed at helping commissioners and service providers better understand hepatitis C treatment pathways.
The Hepatitis C Commissioning Toolkit, an update to the original toolkit published in September 2013, sets out key commissioning responsibilities, with the intention of bringing clarity to an often highly fragmented commissioning landscape.
In a foreword to the toolkit, Dr Steve Ryder, chairman of HCV Action and Consultant Hepatologist at, Nottingham University Hospitals NHS Trust, said: “With new treatments becoming available that can cure upwards of 95% of people, we now have the opportunity to eliminate this preventable and curable virus. “Commissioners have a major role to play. It is no exaggeration to say that commissioners, whether based in local authorities, CCGs or NHS England, will decide whether nor not we capitalise on the opportunity we now have to tackle this costly virus and ultimately eliminate it.”
To find out more > click here.
A new free digital resource called Guidelines for Nurses is available and delivers content that includes guideline summaries, feature articles, and educational resources to help with CPD and revalidation. The resource is available as an app and online.
The app is available to download from the Guidelines for Nurses website for an annual subscription fee of £49.99 HOWEVER access to the content on the app is FREE to all UK-based nurses who register for free on the website first.
Guidelines for Nurses includes a resource centre focussed on liver disease, and one of our most popular pieces of content is the NICE guideline on non-alcoholic fatty liver disease.
To register on the Guidelines for Nurses website > click here.
Some patients with non-alcoholic steatohepatitis (NASH) show recurrence of fibrosis as early as six to 12 months following their transplant.
This emerged in a study at the Medical University of Vienna which compared the recurrence of liver fibrosis in 15 patients transplanted for NASH with 12 to cryptogenic cirrhosis (CC) patients after orthotopic liver transplantation (OLT) between 2004 and 2015.
The case load for OLT because of NASH was constantly increasing (two in 2004-2007 compared with nine in 2012-2015) whilst decreasing for CC (six in 2004-2007 compared with two in 2012-2015). Patient characteristics at OLT were similar, except for an older age and a higher BMI in the NASH patients.
Although post-OLT plasma lipid levels and the incidence of de-novo hypertension, diabetes, and hyperlipidemia were similar between groups, the post-transplant NAFLD fibrosis score (NFS) re-increased in the NASH group but not in the CC group (-0.1317 versus -1.3645 at 12 months post-OLT.
The post-transplant course of patients undergoing liver transplantation for nonalcoholic steatohepatitis versus cryptogenic cirrhosis: a retrospective case-control study. Unger LW, Herac M, Staufer K et al. Eur J Gastroenterol Hepatol. 2016 Dec 2 [Epub ahead of print]
A new study has concluded that the new direct-acting antivirals (DAAs) are highly effective with minimal adverse effects for the treatment of HCV in haemodialysis, and are a very important advance in HCV management.
In this retrospective study, HCV antibodies were analysed in 465 patients at two Madrid hospitals. Positive antibodies were found in 54, and, among these, 29 with genotypes 1 and 4 were treated with different DAA regimens, including combinations of paritaprevir/ritonavir, ombitasvir, dasabuvir, sofosbuvir, simeprevir, daclatasvir and ledipasvir, with/without ribavirin. The most important aetiology of chronic kidney disease involved glomerular abnormalities.
In all cases, a sustained viral response was achieved after 24 weeks, regardless of DAA regimen received. Adverse effects were not relevant and no case required stopping treatment. In 15 cases, ribavirin was combined with the DAA. In these cases, the most significant adverse effect was an anaemic tendency, which was reflected in the increase of the dose of erythropoietin stimulating agents, although none required transfusions.
Effectiveness of direct-acting antivirals in Hepatitis C virus infection in haemodialysis patients. Abad S, Vega A, Rincón D et al. Nefrologia. 2016 Nov 30 [Epub ahead of print]
Although tenofovir (TDF) was more effective at three months, there was no significant difference between TDF and entecavir (ETV) in the long-term treatment of HBV related liver cirrhosis, a new meta-analysis of studies found.
A literature search, conducted by reviewers from Beijing You'an Hospital, found significant difference of ALT norm level at three months (RR 1.43) and six months (RR 0.89), and significant difference of undetectable HBV-DNA only at three months follow-up period (RR 1.59) between TDF and ETV, but no significant difference in the long-term period. There was a significant difference between TDF and ETV in eGFR level (RR 1.601) and hypophosphatemia incidence (RR 4.008).
The efficacy and safety comparison between tenofovir and entecavir in treatment of chronic hepatitis B and HBV related cirrhosis: a systematic review and meta-analysis. Han Y, Zeng A, Liao H et al. Int Immunopharmacol. 2016 Dec 1;42: 168-175 [Epub ahead of print]
On 6th December the APPG on Alcohol Harm has launched its report on the Impact of alcohol on the emergency services.
The Frontline Battle report Download Alcohol Health Alliance The Frontline Battle.pdf reveals the full extent of the pressures and dangers alcohol related problems place on our emergency services and the impact this has on the staff who serve on the frontline.
As part of the Inquiry, the group of parliamentarians took evidence from police officers, fire crew and paramedics, and also collected written evidence.
A press release can be found below:
Abused, attacked and over stretched - Parliamentary report lays bare the impact of alcohol on our emergency services
At an event in Parliament on Tuesday 6th December a report from the All Party Parliamentary Group on Alcohol Harm revealed the full extent of the pressures and dangers alcohol related problems place on our front line emergency services.
The group of parliamentarians took evidence from police officers, fire crew and paramedics, and also collected written evidence, including extensive surveys of emergency service staff across England. Findings in the report include:
• Over 50% of police officers report that alcohol related incidents make up the majority of their workload.
• Surveys find that over 80% of police officers had been assaulted by people who had been drinking, and of those more than 20% had been assaulted six or more times.
• 59% of female police officers and 33% of male officers report sexual assault or harassment while on duty.
Ambulance and A&E departments:
• Over 70% of all attendances at A&E departments are alcohol related at weekends.
• Drunken patients regularly cause significant problems for clinical staff and other patients, with clinicians reporting that they face aggression, violence and being personally assaulted by drunken patients.
• On average alcohol related fires cost almost five times as much as other fires, and are more likely to involve fatalities.
• Fire and rescue services now rescue more people from road traffic collisions than from house fires, with drink driving a continuing problem.
The group of Parliamentarians were also told that alcohol puts a significant and damaging strain on our emergency services, and that many of these incidents were avoidable if the right action was taken.
See the report introduction for quotes from emergency service personnel – Download Alcohol Health Alliance The Frontline Battle.pdf
Fiona Bruce MP, Chair of the All Party Parliamentary Group on Alcohol Harm, said: “It should be wholly unacceptable to hear of an A&E consultant being kicked in the face, medical staff having TV’s thrown at them, or female police officers being sexually assaulted. And it’s not just emergency staff who suffer; as this report describes many other people are impacted too, from taxpayers who foot the bill, to patients who can’t be seen promptly, or worse, those innocent people killed in avoidable drunk driving accidents.”
“Urgent action, as described in this report, is needed from Government at the highest level in order to address this.”
Steve Irving, Executive Officer of the Association of Ambulance Chief Executives, said: “The ambulance service attends too many patients suffering from alcohol-related injuries or illnesses, many of which would not occur without the consumption of excess alcohol. This takes valuable resources away from patients who may be seriously ill so it is clear that more widespread safe drinking, in moderation, would significantly relieve the pressure on ambulance services and the wider health economy, especially emergency departments of local hospitals.”
“ The ambulance service also attends many alcohol-related road traffic collisions each year, some of which result in death and serious injury to members of the public. This is why AACE is actually in favour of ultimately lowering the drink driving limit to zero.”
Amongst others, the report recommendations include:
• A Government-led, cross-departmental National Strategy, to engage all of the appropriate Government Departments on a strategic level.
• Lowering the drink drive limit in England and Wales from 80mg alcohol/100ml blood to 50mg/100ml. This would reduce drink driving fatalities by at least 10%, and is supported by many motoring and roads safety charities, as well as 77% of the British public.
• Reducing the affordability of cheap and high-strength alcohol, by introducing a minimum unit price (MUP) for alcohol, and reinstating the alcohol duty escalator in order to ensure the tax system both addresses alcohol harm, and incentivises the development and sale of lower strength products.
Alcohol Concern provides the secretariat for the All Party Parliamentary Group on Alcohol Harm and welcomes the recommendations made by the report.
Joanna Simons, Chief Executive of Alcohol Concern, said: “The costs of alcohol harm to the UK are huge, not only in terms on lives lost but also through the significant impact on society and our emergency services. Alcohol costs us all, even when we’re not buying alcohol ourselves.”
“What this report highlights is the enormous pressure our emergency service staff face every day. We need the UK Government to act and take steps to implement the report’s recommendations, including lowering the drink drive limit and tackling cheap and high-strength alcohol, which we know will work in reducing alcohol-related harms and ease the strain on frontline staff.”
The report provides a full list of recommendations – Download Alcohol Health Alliance The Frontline Battle.pdf
For more information, please contact: Office of Fiona Bruce MP: firstname.lastname@example.org / Tel: 0207 219 2969
(1) Institute of Alcohol Studies. Drink driving factsheet
(2) Allsop R, (2015)., ‘Saving Lives by Lowering the Legal Drink-Drive Limit’. PACTS
In October the Hepatitis C Coalition, Public Health England and Local Government Association held a workshop on ‘Testing Times: Maintaining and Improving Public Health Testing Services.’
To view a report of the event click > here.
Enter the 2017 BJN Awards today!
The BJN Hepatology/Liver Nurse of the Year award will recognise nurses who care for and treat very unwell patients with a range of life-altering conditions and diseases. The important work within this specialty should be recognised and any nurse who has made a special impact on hepatology/liver nursing should apply or be nominated.
Many people's lives are touched by these conditions and diseases, and whether they practice in hospitals or the community, nurses will find themselves caring at some stage for such patients.
This Award will recognise an individual or team who have made a demonstrable improvement to the delivery of excellent patient care.
Entries close on 12 December 2016 so nominate a colleague today by visitng the BJN website by clicking here.