Clinical News

TNF-alpha inhibitors and TB

Thursday, 24 July 2014 13:43

The Medicines and Healthcare products Regulatory Agency (MHRA) has issued a statement concerning the risk of tuberculosis with tumour necrosis factor alpha (TNF-alpha) inhibitor treatment. The MHRA published an article in the April issue of its monthly Drug Safety Update bulletin reminding healthcare professionals of the increased risk of tuberculosis in patients receiving TNF-alpha inhibitors, the recommendation for screening and monitoring patients, and that there is a patient alert card which should be given to patients. The article can be viewed on the MHRA website:

The practical management of the gastrointestinal symptoms of pelvic radiation disease

Monday, 14 July 2014 14:33

Misc authors, July 2014

A new report from Jervoise Andreyev and his team at the Marsden was published as an open access article in Frontline Gastroenterology and can be found via the following link:

Macmillan funded the design and print of a formatted version to be used in practice by professionals and an online version of that can be found here: www.macmillan.org.uk/prdgastroguidance.

Macmillan are now starting to draft a 'quick guide' version of this report for use in primary care. This document will provide GPs with information about how to identify patients with chronic GI effects of cancer treatment and what tests and interventions they can do, and finally guidance on when a referral needs to be made to a specialist.

Guidance on Decontamination of Equipment for Gastrointestinal Endoscopy: 2014 Edition

Thursday, 10 July 2014 13:57

The Report of a Working Party of the British Society of Gastroenterology Endoscopy Committee

June 2014

The 2008 guidance has been updated so as to incorporate the following developments:

  • The English Department of Health "Choice Frameworks for Local Policies and Procedures (CFPPs)" and equivalent documents from the devolved administrations.
  • Implications arising from moving decontamination facilities out of endoscopy units to centralised facilities, in some cases outside of the hospital campus; in particular the need to ensure a moist environment for endoscopes following last patient use and before decontamination, and conversely the maintenance of a dry storage state following decontamination and before next patient use.
  • Review of vCJD transmission risks, given that at the time of writing there are no known examples of vCJD arising as a result of endoscopy or surgery; guidance on decontamination of endoscopes following the performance of procedures in at-risk individuals is discussed, and quarantining of endoscopes is now deemed rarely necessary.
  • Some references to newer technologies such as NOTES and cholangioscopy.
  • A move away from enzymatic detergents, which have been linked to occupational dermatitis and asthma.
  • The introduction of audit tools, workforce recommendations and educational frameworks.

It is also acknowledged that there are many "stakeholders" in the field of decontamination. This, together with varying guidance from the devolved administrations, has frequently led to inconsistencies and misunderstandings. Against this background BSG Council has agreed that BSG will no longer co-ordinate revisions of its guidance, but a member of BSG Endoscopy will represent the Society on the Professional Expert Organisation Forum that has been established under the auspices of the Institute of Decontamination Sciences.

Finally Miles Allison would like to acknowledge the help and support of so many colleagues during his 12 years of involvement in this arena, in particular Tina Bradley, Helen Griffiths, Libby Thomson, Geoff Ridgway, Mike Bramble and the late Prof Don Jeffries.

Vacancies on NICE Quality Standards Advisory Committees (QSAC)

Tuesday, 08 July 2014 10:07

NICE is currently recruiting for additional members to join their Quality Standards Advisory Committees (QSAC) to support delivery of the library of quality standards topics.

NICE's quality standards are central to supporting the Government's vision for a health and social care system focussed on delivering the best possible outcomes for people who use services. Derived from NICE guidance and other accredited sources, they are a concise set of prioritised statements designed to drive measurable quality improvements within a particular area of health or care. The standards are also used to develop indicators for potential inclusion within the Clinical Commissioning Groups Outcome Indicator Set (CCGOIS) and Quality and Outcomes Framework (QOF) for general practice.

Page 1 of 17