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Burden of Global Health Must Be Shared

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Burden of Global Health Must Be Shared NEWS CollegeWINTER 2015 Burden of global health must be shared INSIDE END OF PRESIDENCY JUNIOR DOCTORS’ CONTRACTS SCOTTISH HEALTH AWARDS ON THE FRONT LINE CAREER JOURNEY INFOGRAPHIC A leap forward in the management of heart failure How NT-proBNP could help reduce rehospitalisations and improve patient outcomes Heart failure is a major, global health problem associated with high Studies have shown NT pro-BNP to be useful as a prognostic morbidity and mortality. Recent research by the ISD Scotland has marker in a range of situations. The ASTRONAUTvi and the I-Preserve identified coronary heart disease (CHD), which includes heart attacks, trialvii found that serial testing and a decreasing trajectory of as a leading cause of illness in Scotland and led to 7,239 potentially NT-proBNP in the early hospital discharge phase carried an avoidable deaths in 2013.i Furthermore, Scotland has a high prevalence independent prognostic value. Increasing levels of NT-proBNP of the risk factors associated with heart disease such as smoking, poor following hospital discharge identifies patients who are at highest diet and physical inactivity. risk of recurrent adverse events. Pooled analyses of chronic HF and biomarker-based studies (positive and negative) indicates a 20% Treating and preventing heart disease is a national clinical priority to 25% adjusted reduction in mortality associated with biomarker- for Scotlandii and it is estimated that around 7.1% of men and 5.3% guided care on top of standard management.viii of women are living with CHD.iii Although deaths from heart disease in Scotland are falling, early identification strategies and optimal risk NT-proBNP also offers less than 0.01% cross reactivity with nesiritide. stratification are healthcare priorities in an attempt to slow the disease BNP demonstrates a high level of cross reactivity with nesiritide, thus, progression. Now, there’s an innovative biomarker to help clinicians. limiting BNP’s value during nesiritide therapy. In these cases you can The Roche Elecsys®NT-proBNP test, accurately provides healthcare still use NT-proBNP. Its near absolute specificity (less than 0.01% professionals with the answers they need in the prognosis and crossreactivity with BNP)ix makes it a valuable marker for monitoring monitoring of heart failure (HF). improvement in patients being treated with recombinant BNP.x Once diagnosed with HF the patient’s ventricular function and long-term NT-proBNP has been conclusively shown to outperform established outcomes continue to deteriorate. Approximately one in four patients cardiovascular disease (CVD) markers in a number of areas. It is a hospitalised with HF will be re-hospitalised within 30 days of discharge. useful marker for the detection, prognosis and monitoring of CVD Many HF rehospitalisations are preventable, but effective strategies to and one clinicians should not be without. prevent rehospitalisations are under utilised costing both health services and potentially compromising the health of patients. References i IDS Scotland. (2015) Heart Disease Statistics Update. Serial measurements of NT-proBNP, together with conventional ii NHS Scotland. (2009) Better Heart Disease and Stroke Care Action Plan. clinical assessment can assist in pharmacotherapy decision making iii The Scottish Government. (2014) Scottish Health Survey. and improve patient outcomes.iv When measured in the acute phase iv B.DeBaradini et al. (2012) CurrOpinCardio, 27(6):661-8. following myocardial infarction (MI), for example, NT-proBNP is a v S. Talwar et al. (2000) Euro Heart Journ. 21(18): 1514-1521. stronger predictor of poor clinical outcomes than BNP when measured vi Greene, SJ, et al. (2015). Euro Journ of Heart Fail, 17: 98-108. vii Jhund, PS, et al. (2014). Euro Journ of Heart Fail, 16: 671-677. by death or LV systolic dysfunction. At 72-120 hours after MI, it is also viii Januzzi. (2011). Journal of Cardiac Failure 17(8). superior to clinical, radiological or ECG parameters in the identification ix K-T J Yeo et al. (2003) Clinica Chimica Acta. 338: 107-115. of impaired LV systolic function.v x RL Fitzgerald et al. (2005) AHJ. vol. 150 (3): 471 - 477. 214589-CN-ROCHE FPA.indd 1 01/09/2015 15:31 IN THIS ISSUE Editor: From the President’s Office 02 DENTAL UPDATE 20 Elaine Mulcahy COLLEGE NEWS 03 TRAVEL MEDICINE UPDATE 22 [email protected] TALKING POINT 08 PODIATRIC MEDICINE UPDATE 24 Production: Junior doctors’ contracts Carl Barton LIBRARY AND HERTAGE 26 [email protected] COLLEGE IN ACTION 09 Time to tackle obesity New tool to help health professionals encourage physical activity If you are interested in contributing IN FOCUS 10 Burden of global health to College News please email: 03 [email protected] ON THE FRONT LINE 12 with Jane Chiodini WHAT’S ON 11 PHYSICIANS UPDATE 16 www.rcpsg.ac.uk SURGEONS UPDATE 18 END OF PRESIDENCY @rcpsglasgow 07 06 /RCPSG royal-college-of-physicians-and- surgeons-of-glasgow College News is the magazine of the Royal College of Physicians and JUNIOR DOCTORS’ SCOTTISH HEALTH Surgeons of Glasgow published by CONTRACTS DISPUTES AWARDS 10 12 Excel Publishing Co Ltd 6th Floor, Manchester One 53 Portland Street BURDEN OF GLOBAL ON THE FRONT LINE Manchester M1 3LD HEALTH MUST BE SHARED Tel: 0161 236 2782 www.excelpublishing.co.uk 24 19 Advertising sales: John Cooper – 0161 661 4192 [email protected] PEFC Certied This product is CAREER JOURNEY MRCS COMING TO from sustainably managed forests and controlled sources BANGALORE PEFC/16-33-576 www.pefc.org www.rcpsg.ac.uk College News Winter 2015 1 WELCOME FROM THE PRESIDENT’S OFFICE Watch the President’s video at http://rcp.sg/cnwinter15video Our College has many Fellows and The Medicine24 two day symposium was component to visitors. It will also increase Members in England and training issues in a landmark day for the College. Jackie the public’s understanding of the College. the UK remain very much the responsibility Taylor and colleagues put the programme This comes at an opportune time with of all four nations. In view of this we have together and I am sure even they did the recent award to the college of been following the junior doctors’ dispute not anticipate the demand for places. Museum Accreditation status thanks to the closely. The outcome of the recent ballot Eventually five locations were used via leadership of Carol Parry. Carol recently of junior doctors overwhelmingly favoured video streaming, three of which were local retired after 20 years of outstanding industrial action. We are supportive of hospitals which permitted the attendance service the College, recognised by many of the issues raised by our junior of undergraduate students at no charge. conferring upon her fellowship of the colleagues and will continue to do all we The number of attendees exceeded College. can to persuade both sides to negotiate 450 illustrating that if the programme is without preconditions. relevant and of high quality, it will sell out. I approach the end of my three year Many other challenges exist in the NHS, I have been keen throughout my term as President with mixed emotions. none more than the issue of recruitment Presidency to meet many of our Fellows There will be a big gap to fill. I have many and retention of medical staff. I have and Members who, because of their happy memories. I have met remarkable previously expressed concerns regarding location, are unable to attend events people both locally and beyond who have trainees. Recent figures for cancelled in Glasgow. We have had a number of enhanced my perspective on life. I have consultant appointment committees in successful events around the UK including worked within a Royal College which has Scotland (i.e. unfilled consultant posts) two successful symposia in Inverness and so many committed staff and none more are of concern, and more so than in Gateshead this year. In addition, we have than the Chief Operating Officer, John England. The reasons for this are complex had a number of successful international Cooper. New ideas and developments are but are likely to include the introduction visits, specifically to India and Oman. We evaluated thoroughly and timeously thus in Scotland of 9/1 contracts in 2010. are also showing our commitment to allowing changes where appropriate to Throughout my presidency I, with other our international Fellows and Members be made without delay. The admission presidents, have consistently lobbied the through the recent appointment of an ceremonies have been a highlight as have Scottish Government to move away from international director and international the many highly successful educational these dispiriting contracts. I believe that manager who will support our ongoing events within College. I do feel strongly some progress is being made but much development outwith the UK. that three years is the right term of office still needs to be done. An aggressive drive and that it is right and proper that the is required to recruit more consultants We are excited by the ongoing building outgoing President should be just that and to Scotland and also to continue to work developments and are using the allow the new President to put his own on recruiting and retaining sufficient opportunity presented by the purchase mark on the College. I am confident that numbers of trainees to fill the consultant of 19 Blythswood Square to redesign David Galloway has all the qualities to vacancies. We also have a responsibility to the office accommodation in St Vincent make an excellent President and he has my promote our profession at every available Street. This includes plans to have a cafe very best wishes. opportunity. We are committed to working area for Staff, Fellows, Members and the with the Scottish Government on this public.
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