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CEBD-EVIDENCE-UPDATES  June 2006

CEBD-EVIDENCE-UPDATES June 2006

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Subject:

NLH Skin Disorders Specialist Library Update - June 2006

From:

Douglas Grindlay <[log in to unmask]>

Reply-To:

NLH Skin Disorders Specialist Library Newsletter <[log in to unmask]>

Date:

Fri, 30 Jun 2006 15:00:46 +0100

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (172 lines)

+++ NLH Skin Disorders Specialist Library Update - June 2006

++ Contents:

Section One: Introduction
Section Two: Newly published resources
01: NPSA Patient Safety Alert 13 - Improving compliance with oral methotrexate guidelines
02: BAD resources page - NPSA Patient Safety Alert June 2006: Improving compliance with oral methotrexate guidelines
03: Oral methotrexate pre-treatment patient information leaflet (BAD 2006 modified version)
04: Sexually transmitted infections in primary care (RCGP Guidelines)
05: Cochrane Review - Interventions for cutaneous molluscum contagiosum
06: Cochrane Review - Preoperative bathing or showering with skin antiseptics to prevent surgical site infection
07: Cochrane Review - Preoperative hair removal to reduce surgical site infection
08: Clinical Evidence topic - MRSA (treatment)
09: HTA Monograph - A systematic review of the clinical effectiveness and cost-effectiveness of enzyme replacement therapies for Fabry's disease and mucopolysaccharidosis type 1
10: BAD Agreed List of 'Specials' in Dermatology
Section Three: Resources recently added to the Skin Disorders Specialist Library
11: Minimum dataset for the histopathological reporting of common skin cancers (Royal College of Pathologists)
12: Making psoriasis a priority: an independent report
Section Four: Events
Section Five: Notes



++ Section One: Introduction.


Welcome to the June 2006 Update from the NLH Skin Disorders Specialist Library.

If you find this e-mail newsletter useful please tell your colleagues, and feel free to forward it others who might be interested.  We welcome all feedback and suggestions for improvement, either by the "Contact us" facility on the website or by e-mail to Douglas Grindlay at [log in to unmask]

As the URLs for database records in the Library are very long, it is not practical to give individual links in this text-based e-mail, as they will spill over several lines and may not work in some e-mail readers.  However, links to all recently added items in the Library can be found in the "What's new" section of the home page at www.library.nhs.uk/skin.

For the latest news in dermatology, visit the Library's News section, which is available by clicking the "News" button near the top of the left-hand menu, or by following this link:  http://libraries.nelh.nhs.uk/skin/news.asp.



++ Section Two: Newly published resources.

+01: NPSA Patient Safety Alert 13 - Improving compliance with oral methotrexate guidelines

This guidance from the National Patient Safety Agency (NPSA) seeks to reduce the risk of patient harm associated with the incorrect use of oral methotrexate and to ensure that local monitoring and clinical practice are consistent across the NHS. It aims to ensure that all actions described in the original alert of 2004 are completed, recommending that NHS organisations give patients the core patient information leaflet and monitoring document which have been reviewed in collaboration with the British Society for Rheumatology (BSR) and the British Association of Dermatology (BSD).


+02: BAD resources page - NPSA Patient Safety Alert June 2006: Improving compliance with oral methotrexate guidelines

This page of the BAD website has links to various documents relating to the updated Patient Safety Alert for all physicians, pharmacists and nurses involved with prescribing, dispensing or monitoring low dose methotrexate, which was issued on June 1st 2006 by the NPSA (see item 01 above).


+03: Oral methotrexate pre-treatment patient information leaflet (BAD 2006 modified version)

This modified version of the revised NPSA patient information booklet on methotrexate has been produced by the British Association of Dermatologists (BAD). A short introductory section summarising the use of methotrexate in psoriasis and other skin diseases has been added.


+04: Sexually transmitted infections in primary care (RCGP Guidelines)

This document addresses the need for accurate information about sexually transmitted infections (STIs) to be readily available in GP surgeries.  The format is a quick reference guide to STIs which aims to raise GP awareness and be of help with pragmatic in-surgery management.


+05: Cochrane Review - Interventions for cutaneous molluscum contagiosum

This Cochrane systematic review found that many common treatments for molluscum contagiosum, such as physical destruction, have not been adequately evaluated and there is not enough evidence to show that any particular treatment is effective. It is concluded that since most lesions will resolve within months without leaving scars, molluscum contagiosum can be left to heal naturally until better evidence on treatment options emerges.


+06: Cochrane Review - Preoperative bathing or showering with skin antiseptics to prevent surgical site infection

This systematic review concludes that using the antiseptic chlorhexidine for preoperative bathing or showering is unlikely to prevent surgical site infection, and there is no benefit with chlorhexidine over other wash products. Efforts to reduce the incidence of hospital-acquired site infection should focus on interventions where effect has been demonstrated.


+07: Cochrane Review - Preoperative hair removal to reduce surgical site infection

This systematic review concludes there is insufficient evidence for removing hair before surgery by shaving or applying depilatory cream as a way of reducing the rate of surgical site infection. However, if it is necessary to remove hair, then it is preferable to use clippers rather than shaving with a razor as this results in fewer surgical site infections.


+08: Clinical Evidence topic - MRSA (treatment)

This Clinical Evidence topic evaluates the treatments for methicillin resistant Staphylococcus aureus (MRSA) and categorises them according to the evidence on their benefits and harms. For MRSA infection of any body site, linezolid and the glycopeptides teicoplanin and vancomycin are judged to have a trade off between benefits and harms.  A wide range of other treatments, including macrolides, quinolones and tetracyclines, are judged to be of unknown effectiveness. For MRSA nasal and extra-nasal colonisation, the treatments reviewed are mupirocin nasal ointment (likely to be beneficial); antiseptic body washes, chlorhexidine-neomycin nasal cream, mupirocin nasal ointment for 5 days and systemic antimicrobials (unknown effectiveness); and tea tree preparations (unlikely to be beneficial).


+09: HTA Monograph - A systematic review of the clinical effectiveness and cost-effectiveness of enzyme replacement therapies for Fabry's disease and mucopolysaccharidosis type 1

Although enzyme replacement therapy (ERT) for treating the 'average' patient with Fabry's disease exceeds the normal upper threshold for cost-effectiveness seen in NHS policy decisions by over sixfold, and the value for mucopolysaccharidosis type 1 is likely to be of a similar order of magnitude, clinicians and the manufacturers argue that, as the disease is classified as an orphan disease under European Union legislation, it has special status and the NHS has no option but to provide ERT. More information is required before the generalisability of the findings can be determined.


+10: BAD Agreed List of 'Specials' in Dermatology

This is a working, rationalised list of unlicensed and 'special manufacture' medicines ('specials') that may be specially manufactured and supplied in NHS hospitals for the treatment of dermatological conditions. It has been produced by the British Association of Dermatologists (BAD) following a consultation process with BAD members. The aim is to 'rationalise the present situation and improve reliability of supply as well as decreasing costs overall.'



++ Section Three: Resources recently added to the Skin Disorders Specialist Library.

+11: Minimum dataset for the histopathological reporting of common skin cancers (Royal College of Pathologists)

These guidelines from the Royal College of Pathologists describe optimal core data which should be included in common skin cancer histopathology reports (for melanoma, basal cell carcinoma and squamous cell carcinoma).  They aim to aid patient management and treatment, to provide accurate prognostic information for patients and clinicians and to create a common database for clinical audit and effectiveness.


+12: Making Psoriasis a Priority: an Independent Report

Making Psoriasis a Priority is a report from the Skin Care Campaign & the Psoriasis Association that pulls together comprehensive information on psoriasis, including the physical and psychological impact of the disease, treatments and dermatology services. The document is aimed at key decision makers and senior providers within the NHS, as well as parliamentarians.



++ Section Four: Events.


+ 31st August-2nd September - International Society for Dermatologic Surgery, 27th Annual Congress, Istanbul.

+ 7th-9th September 2006 - European Society for Dermatological Research (ESDR), 36th Annual Meeting, Paris.

+14th-16th September 2006 - Perspectives in Melanoma X and the Third International Melanoma Research Congress, Noordwijk, The Netherlands.

+ 21st September 2006 - PCOS UK (polycystic ovary syndrome) Conference 2006, Manchester.

+ 3rd-7th October 2006 - European Academy of Dermatology and Venereology, 15th Congress, Rhodes.

+ 9th-10th October 2006 - Skin and Formulation 2nd Symposium, Versailles, France.

+ 19th-20th October 2006 - BSDS Advanced Surgery Workshop, Newcastle/Gateshead.

+ 29th October 2006 - World Psoriasis Day.

+ 17th-18th November 2006 - Cancer and the Skin - BAD Annual UK Dermatology Course for Consultants, London.


For details of the above events please click on the "Events" tab in the Library or follow this link:
http://rms.nelh.nhs.uk/skin/events.asp.

If you are organising a conference or other event of interest to health professionals in the field of dermatology, please let us know and we can add it to our events diary.



++ Section Five: Notes.


This newsletter has been produced using the Text Email Newsletter (TEN) Standard, which is designed to improve the readability of plain text email newsletters by all readers, including people with visual impairments using special access technologies.  For more details see the homepage for the TEN Standard: http://www.headstar.com/ten/.

The provision of a link to an item in this newsletter shall not be taken as an endorsement of any kind.  Whilst reasonable efforts have been made to ensure the accuracy of the information in this newsletter, we cannot guarantee its correctness or completeness.

To join or leave this news group please visit the NLH-SKIN-CONDITIONS registration page on the JISCmail web site:
http://www.jiscmail.ac.uk/cgi-bin/webadmin?SUBED1=nlh-skin-conditions&A=1.


[Document ends].


***********************************************
Dr. Douglas Grindlay
Dermatology Information Specialist
NLH Skin Disorders Specialist Library

Centre of Evidence Based Dermatology
Room A103
King's Meadow Campus
University of Nottingham
Nottingham
NG7 2NR

Tel: 0115 8468630

E-mail: [log in to unmask]

www.library.nhs.uk/skin
www.nottingham.ac.uk/dermatology
***********************************************

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