College News - November 2010RCPE Press Release ANTIBIOTICS VOTED THE MOST IMPORTANT MEDICAL DEVELOPMENT IN THE LAST 50 YEARSDoctors have voted antibiotics as the most important medical development in the last 50 years in a poll organised by the Royal College of Physicians of Edinburgh (RCPE). The poll was conducted to mark a forthcoming RCPE conference celebrating five decades of medical achievement [1]. The RCPE has a widespread membership throughout Scotland, the UK and internationally and surveyed its members on the Top 20 most important medical developments to have occurred in the last 50 years. Antibiotics came first in the poll when analysing the results from a Scottish, UK and worldwide perspective. While antibiotics were first discovered in the 1940s their medical application and further development really only took off in the 1960s since which time they have saved countless lives worldwide and have become the most important weapon at a doctor’s disposal in fighting infection. The development and use of antibiotics was followed at the top of the poll by vaccination (against infectious diseases) and developments in imaging (most notably CT and MRI scanning). A full list of the Top 20 most important developments is included within this press release [2]. Dr Neil Dewhurst, President of the Royal College of Physicians of Edinburgh, said, “During the last 50 years we have witnessed many major advances in medicine, some of which would have seemed inconceivable to doctors and the public alike in the 1950s and 1960s. These advances now provide patients with unprecedented levels of medical treatment and have been instrumental in both alleviating and preventing many forms of disease. “As an individual, it is difficult to say which singular development has been the most important, as all doctors will have their own views regarding which development has been the most beneficial within their own area of specialisation, be it cardiology or infectious diseases. “The central role of the RCPE is to promote the highest standards in medicine both nationally and internationally. In celebrating our 50th anniversary symposium, focussing on Five Decades of Medical Progress, we thought it appropriate to survey our members in order to ask them what they believed to be the most important developments in order to highlight and celebrate these medical milestones. “From the results of this survey it is clear that doctors throughout Scotland, UK and internationally believe the most important developments to be in relation to the availability of effective antibiotics and vaccination. Whilst agreeing with this point, it is also vital that doctors and patients are aware of the dangers of over-using antibiotics and that antibiotics are prescribed safely and wisely in order to reduce the risk of drug-resistance and problems like MRSA and C. difficile. “It is also interesting to note how significantly Scottish doctors and scientists have contributed to these global developments. For centuries Scotland has had a reputation as a leader in medical innovation and we are gratified that this tradition continues to this day”. Contact: Graeme McAlister on 07733-263453 or 07808-939395 ENDS Notes to Editors [1] RCPE St. Andrew’s Day Symposium: Five Decades of Medical Progress, 2-3 December 2010, [2] TOP 20 MOST IMPORTANT MEDICAL DEVELOPMENTS IN THE LAST 50 YEARS
RCPE Press Release Doctors Urge Heightened Vigilance For Sudden Cardiac Death in Young PeopleDoctors meeting at a conference organised by the Royal College of Physicians of Edinburgh (RCPE), will, today (Tuesday 23 November 2010), urge the public and medical staff to be much more vigilant in seeking to prevent sudden cardiac death in children and young people – a ‘hidden’ disease which causes an estimated 600 sudden deaths in children and young people in the UK each year. Sudden cardiac death is an umbrella term for a range of underlying, inherited, forms of heart disease which if not detected early can result in sudden death. Sudden cardiac death affects 2 in 100,000 people under age 35 each year (equivalent to 600 deaths in the UK annually). Due to the nature of sudden cardiac death, those affected can often go for many years without outwardly displaying symptoms which would be commonly recognised as requiring medical treatment or investigation. Other individuals may be seen by medical staff following loss of consciousness initially thought to be a faint or an epileptic seizure, when such symptoms can in rare cases be a potential predictor of sudden cardiac death. In some young people sudden cardiac death can be preceded by other events such as sporting activity which, whilst not the cause of death, triggers the potentially fatal change in heart rhythm associated with the underlying condition. In order to identify those at risk, screening has been proposed. In recognition of this, the Scottish Government piloted a two-year project with the Scottish Football Association and the University of Glasgow from 2008-10 during which 800 athletes in the 15-25 age group were screened, resulting in the identification of 42 young people with a family history of sudden death and one potentially serious case of heart muscle disease (cardiomyopathy). This project has recently been extended for a further two years. Whilst sudden cardiac death in children and young people is quite rare, and despite the ongoing Scottish Government pilot involving those involved in sport, there is a much lower level of public awareness regarding this disease than other forms of sudden death, including Sudden Infant Death Syndrome (SIDS) about which there is a very high level of awareness following health information campaigns. Dr Andrew Grace, Consultant Cardiologist, Papworth Hospital, Cambridge, said, “Evidence has shown the likelihood of sudden cardiac death can be greatly reduced through the combined careful consideration of symptoms including loss of consciousness, chest pain, breathlessness, palpitations or seizures and the taking of a detailed family history. In addition to noting a family history of heart disease, doctors and patients should pay particular attention to a family history of sudden unexplained death, car accident or unexplained drowning which could indicate signs of a genetic pre-disposition to sudden cardiac death. By considering such wider factors we can identify the need for referral to a cardiologist, consideration for screening and ultimately save lives”. Dr Neil Dewhurst, President of the Royal College of Physicians of Edinburgh (RCPE), and a Consultant Cardiologist, said, “Sudden cardiac death can have a devastating effect not just in terms of prematurely ending the life of a young person, but also upon their families and friends. In many cases these sudden and unexpected deaths are preventable and at risk individuals can be identified via effective screening fed by greater public awareness. It is essential that the public become more aware of the related symptoms and family indicators of disease in order that we can reduce the number of lives lost needlessly each year. “The Scottish Government is to be applauded for piloting work in this area and extending this for another 2 years. However, it is essential that appropriate cardiac screening should become a core, ongoing, component of future public health policy and strategy, and that we seek ways to identify children under 15 who may be at equal risk to those targeted by this pilot. Successive governments have been hugely influential in raising public awareness about other forms of sudden death, including SIDS, and this has led to a reduction in associated death rates. There is now a need to similarly inform and educate the public about sudden cardiac death in adolescents and young adults.” Contact: Graeme McAlister on 0131-247-3693 or 07733-263453 ENDS Notes to Editors The RCPE Cardiology Symposium will be held at the RCPE, 9 Queen Street, Edinburgh from 9.00am – 4.30pm on Tuesday 23 November 2010. RCPE Comment on Review of Foundation TrainingThe Collins Review of Foundation Training has been published. The main recommendations are that the length of the Foundation Programme should remain unchanged at two years, but this should be reviewed in 2015 when the impact of the General Medical Council (GMC) recommendations in Tomorrow’s Doctors will be clearer, and that action should be taken to strengthen supervision for Trainees, many of whom have had to act beyond their level of competency. Commenting on the Collins Review, Dr Neil Dewhurst, President of the Royal College of Physicians of Edinburgh (RCPE), said, “We welcome the findings of this review which we believe has made a number of important recommendations aimed at strengthening the quality of early medical training of doctors. In particular, we support the recommendations that the system for selection into training should be standardised, that supervision for Trainees should be strengthened and Trainers supported in providing such supervision. “Perhaps most significantly, this Review has recognised the need to define the balance between service and educational needs. It is essential that, in addition to delivering patient care, Trainees receive protected time with which to complete their Training. Failure to do so could lead to a generation of inadequately trained doctors and, in turn, compromise patient safety. Such tensions between service and training requirements are likely to heighten as the impact of the European Working Time Regulations is fully realised and it is vital that this matter is adequately addressed.”
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