By Katherine Hobson

More Cantaloupe Deaths: Eighteen people have now died from listeriosis linked to eating tainted cantaloupes, and the number of illnesses associated with the outbreak rose to 100, the WSJ reports. more illnesses are expected to emerge because it can take up to two months for symptoms to appear after infection, FDA head Margaret Hamburg said yesterday.

Additional Warning: the FDA said Roche’s cancer drug Avastin may cause ovarian failure in some women, the WSJ reports. A warning about the fertility problem was added to the drug’s label, as was updated information about the risk of blood clots and bleeding risk and new information about reports of jaw-bone decay.

Projected TB Deaths: Research published in the BMJ suggests that 40 million smokers could die from tuberculosis by 2050, most of them in Africa and the eastern Mediterranean and Southeast Asian areas of the world, BBC News reports. People who smoke are more vulnerable to TB.

ScienceDaily (Feb. 24, 2011) — Family doctors can take more than a month to record ovarian cancer, once diagnosed by a specialist, in one in 10 cases, indicates research published in the launch issue of the new online journal BMJ Open.

Ovarian cancer was also incorrectly or prematurely classified in 11% of cases, the data show.

The authors base their findings on the "free text" data available in patient records, which are submitted to the General Practice Research Database (GPRD).

The GPRD contains long term anonymised medical data on more than four million patients on the lists of a representative 500 primary care practices across the UK.

The information, which is created during the course of GP consultations or correspondence relating to specialist referrals and diagnostic tests, is widely used for studies on aspects of disease and drug safety.

The authors focused on the Read codes relating to a diagnosis of ovarian cancer in women aged 40 to 80, between 2002 and 2007.

Read codes are used to code symptoms and diagnoses electronically in primary care in the UK. They provide the option to enter free text for each code, such as a letter from the specialist and a date when the ‘event’ occurred.

The authors also looked at this free text information to establish the time lag between when the specialist notified the GP of the diagnosis and the date it was officially coded as such in the patient’s record.

There is a good deal of free text in the database, but it is not always coded by GPs nor accessed by researchers, say the authors.

During the study period, 344 women were given one of three Read codes indicating a diagnosis of ovarian cancer.

Most cases (90%) had free text relating to ovarian disease, and in almost two thirds (64%) this confirmed a diagnosis of ovarian cancer.

But in one in five cases (22%) free text information confirmed this diagnosis before it was officially coded as such in the patient’s record. in one in 10 cases more than four weeks had elapsed.

The free text information also showed that mistakes been made in 11% of the records.

Four cases coded for ovarian cancer did not have the disease at all; in another six cases the cancer was a recurrence which was not evident in the coding. and in 35 cases, patients had been coded before a definitive diagnosis had been made

"for diseases which rely on hospital consultants for diagnosis, free text (particularly letters) is invaluable for accurate dating of diagnosis and referrals and also for identifying misclassified cases," conclude the authors.

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Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by BMJ-British Medical Journal, via EurekAlert!, a service of AAAS.

Journal Reference:

1. A Rosemary Tate, Alexander G R Martin, Aishath Ali, Jackie Cassell. Using free text information to explore how and when GPs code a diagnosis of ovarian cancer: an observational study using primary care records of patients with ovarian cancer. BMJ Open, 23 February 2011 DOI: 10.1136/bmjopen-2010-000025

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Latest Pregnancy News

British Doctors say Risk is Small but Real; U.S. Experts Aren’t so Sure

By Denise MannWebMD Health News

Reviewed by Laura J. Martin, MD

Jan. 27, 2011 — Maternal deaths resulting from in vitro fertilization (IVF) are relatively rare, but they do occur, British doctors warn in an editorial in the journal BMJ.

In the U.S. there were more than 140,000 IVF cycles in 2008, according to the Society for assisted Reproductive Technology (SART). During IVF, an egg and sperm are fertilized outside of the body in a laboratory and then implanted in the woman’s uterus. Fertility drugs are often used to stimulate a woman’s ovaries to produce eggs.

One leading U.S. fertility doctor says he is not aware of any deaths in the U.S. related to IVF pregnancies.

In the new report, Susan Bewley, an obstetrician at Kings College in London, and colleagues cite a study in the Netherlands that shows that the rate of pregnant women dying during IVF pregnancies is higher than during pregnancies in the general population. Specifically, there were 42 deaths per 100,000 IVF pregnancies, compared with six deaths seen among 100,000 pregnancies in the general population.

Ovarian hyperstimulation syndrome can occur as a result of fertility drugs used to stimulate the development of eggs in a woman’s ovaries. If the ovaries are overstimulated they can become enlarged and symptoms such as abdominal pain, nausea, and vomiting can occur. in severe cases fluid may accumulate around the lungs or heart.

The authors call for tracking of IVF-associated risks including ovarian hyperstimulation syndrome to better understand risks associated with IVF. “More stringent attention to stimulation regimens, preconceptual care, and pregnancy management is needed so that maternal death and severe morbidity do not worsen further,” they write.

U.S. Perspective

U.S. fertility doctors point out that the reasons women undergo IVF may account for the increased risk of death seen in the studies.

“It is very tenuous to say these were caused by IVF,” says Jamie Grifo, MD, PhD, program director of new York University Fertility Center in new York City.

Underlying health issues in women who turn to IVF to get pregnant may affect their risk profile, he says. these women may have had previous uterine surgery or are predisposed to high blood pressure or diabetes. Women who undergo IVF are also usually older than their counterparts who conceive without such assistance. Advancing maternal age is associated with riskier pregnancies.

“The population of people who need IVF may add special contributing factors to the risk of death during their pregnancy,” he says. Multiple pregnancies are more likely as a result of IVF, which also increases risks to moms and babies.

The new findings may not apply to the U.S. due to differences in obstetrical care, he says.

“We manage risks better [here], and do reductions more in multiple pregnancies,” Grifo says. the best way to protect the mother’s health and that of the baby regardless of how the pregnancy occurred is good prenatal care.

“If there are things about the pregnancy that increases their risk, women should be cared for by high-risk obstetricians who know how to manage complications and take them seriously,” he says.

Risks Inherent

“I have never heard of anyone dying from IVF in the U.S.,” says SART President R. Stan Williams, MD, the chairman of obstetrics and gynecology at University of Florida in Gainesville.

In the new report, “they are comparing apples to oranges when they compare pregnancy in the general population to IVF pregnancies,” he says.

“The first major difference is the ages,” he says. “The majority of people getting IVF are in their mid-30s, and the majority of women in the general population who get pregnant are in their 20s.”

The underlying disease process that caused fertility problems in the first place is also a factor.

That said, every procedure does have some inherent risks, including IVF.

“There are risks with IVF, I don’t deny it,” he says. “The risks are rare but they are real and need to be taken into account when thinking about using IVF to have a baby.”

Many couples may downplay or even ignore the risks due to their desire to have children, he says.

“It is the physician’s responsibility to make sure they are not driven only by the goal of establishing a pregnancy and that they really understand any and all risks that they are taking,” says Gerald Scholl, MD, associate chief of human reproduction at North Shore University Hospital in Manhasset, N.Y.

He says that the risk of maternal mortality among IVF pregnancies is “really extremely low.”

These women are screened extensively before IVF to make sure they are appropriate candidates.”If women have any underlying diseases or conditions that could worsen during pregnancy, they are counseled not to start IVF,” he says.

SOURCES: Jamie Grifo, MD, PhD, program director, new York University Fertility Center.Bewley, S. BMJ, 2011.R. Stan Williams, MD, chairman, obstetrics and gynecology, University of Florida, Gainesville.Gerald Scholl, MD, associate chief, human reproduction, North Shore University Hospital, Manhasset, N.Y.Society for assisted Reproductive Technology.©2011 WebMD, LLC. All Rights Reserved.

In the video embedded into this post, activist and parent of an autistic child, JB Handley, dismisses a new report declaring a 1998 study linking autism to vaccinations an "elaborate fraud." The full story follows:

(CNN) – A now-retracted British study that linked autism to childhood vaccines was an "elaborate fraud" that has done long-lasting damage to public health, a leading medical publication reported Wednesday.

An investigation published by the British medical journal BMJ concludes the study's author, Dr. Andrew Wakefield, misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the 1998 study – and that there was "no doubt" Wakefield was responsible.

"It's one thing to have a bad study, a study full of error, and for the authors then to admit that they made errors," Fiona Godlee, BMJ's editor-in-chief, told CNN. "But in this case, we have a very different picture of what seems to be a deliberate attempt to create an impression that there was a link by falsifying the data."

Britain stripped Wakefield of his medical license in May. Efforts to reach him for comment were unsuccessful Wednesday. 

"meanwhile, the damage to public health continues, fueled by unbalanced media reporting and an ineffective response from government, researchers, journals and the medical profession," BMJ states.

The now-discredited paper panicked many parents and led to a sharp drop in the number of children getting the vaccine that prevents measles, mumps and rubella. Vaccination rates dropped sharply in Britain after its publication, falling as low as 80% by 2004. Measles cases have gone up sharply in the ensuing years.

In the United States, more cases of measles were reported in 2008 than in any other year since 1997, according to the Centers for Disease Control and Prevention. more than 90% of those infected had not been vaccinated or their vaccination status was unknown, the CDC reported.

"But perhaps as important as the scare's effect on infectious disease is the energy, emotion and money that have been diverted away from efforts to understand the real causes of autism and how to help children and families who live with it," the BMJ editorial states.

Wakefield has been unable to reproduce his results in the face of criticism, and other researchers have been unable to match them. most of his co-authors withdrew their names from the study in 2004 after learning he had had been paid by a law firm that intended to sue vaccine manufacturers – a serious conflict of interest he failed to disclose. after years on controversy, the Lancet, the prestigious journal that originally published the research, retracted Wakefield's paper last February.

The series of articles launched Wednesday are investigative journalism, not results of a clinical study. The writer, Brian Deer, said Wakefield "chiseled" the data before him, "falsifying medical histories of children and essentially concocting a picture, which was the picture he was contracted to find by lawyers hoping to sue vaccine manufacturers and to create a vaccine scare."

According to BMJ, Wakefield received more than 435,000 pounds ($674,000) from the lawyers. Godlee said the study shows that of the 12 cases Wakefield examined in his paper, five showed developmental problems before receiving the MMR vaccine and three never had autism.

"It's always hard to explain fraud and where it affects people to lie in science," Godlee said. "But it does seem a financial motive was underlying this, both in terms of payments by lawyers and through legal aid grants that he received but also through financial schemes that he hoped would benefit him through diagnostic and other tests for autism and MMR-related issues."

Dr. Max Wiznitzer, a pediatric neurologist at Rainbow Babies & Children's Hospital in Cleveland, said the reporting "represents Wakefield as a person where the ends justified the means." But he said the latest news may have little effect on those families who still blame vaccines for their children's conditions.

"unfortunately, his core group of supporters is not going to let the facts dissuade their beliefs that MMR causes autism," Wiznitzer said. "They need to be open-minded and examine the information as everybody else."

Wakefield's defenders include David Kirby, a journalist who has written extensively on autism. he told CNN that Wakefield not only has denied falsifying data, he has said he had no way to do so.

"I have known him for a number of years. he does not strike me as a charlatan or a liar," Kirby said. If the BMJ allegations are true, then Wakefield "did a terrible thing" – but he added, "I personally find it hard to believe that he did that."