Low-dose aspirin should not routinely be used to prevent heart attacks and strokes, contrary to official guidance, say UK researchers.

Analysis of data from over 100,000 clinical trial participants found the risk of harm largely cancelled out the benefits of taking the drug.

Only those who have already had a heart attack or stroke should be advised to take a daily aspirin, they found.

The study should help clarify a “confusing” issue, a leading GP said.

The NHS drugs watchdog, the National Institute for health and Clinical Excellence (NICE), has not made a ruling in this area.

But experts in the UK, US and Europe recommend aspirin for people who have not already had a heart attack or stroke, but are at high risk of cardiovascular disease because of factors such as age, blood pressure and cholesterol level.

This strategy, known as primary prevention, is based on the result of studies looking at predicted risks and benefits in this population.

But the latest research is provides clearer evidence because it is based on data from individuals, the researchers said.

They looked at heart attacks and strokes and major bleeds – a potential side effect of aspirin – in six primary prevention trials, involving 95,000 people at low to average risk and 16 trials involving 17,000 people at high risk – because they had already had a heart attack or stroke.

Use of aspirin in the lower-risk group was found to reduce non-fatal heart attacks by around a fifth, with no difference in the risk of stroke or deaths from vascular causes.

But it also increased the risk of internal bleeding by around a third.

Balance

However, in those patients who had already had a heart attack or stroke and were at risk of having another, the benefits clearly outweighed the chance of adverse events, the researchers said.

Study leader Professor Colin Baigent from the Clinical Trial Service Unit at the University of Oxford, UK, said drug safety was vital when making recommendations that affected tens of millions of healthy people.

“We don’t have good evidence that, for healthy people, the benefits of long-term aspirin exceed the risks by an appropriate margin.”

He added: “I think the guideline groups will find it useful to have the data analysed in that way.”

Professor Steve Field, chair of the Royal College of GPs, said the issue had been confusing for GPs and patients.

“There is no definitive guidance and it makes it bewildering when you have a series of papers which then hint it would be beneficial to take aspirin.”

He added that many patients would buy aspirin over the counter – either on the advice of their GP or under their own steam – because it was cheap.

“This important study does suggest people shouldn’t take aspirin unless indicated by disease.”

Ellen Mason, senior cardiac nurse at the British Heart Foundation said: “It is better for doctors to weigh up the benefit and risk of prescribing aspirin on an individual basis, rather than develop a blanket guideline suggesting everyone at risk of heart disease is routinely given aspirin.”

Malaria parasites ‘resist drugs’

International scientists say they have found the first evidence of resistance to the world’s most effective drug for treating malaria.

They say the trend in western Cambodia has to be urgently contained because full-blown resistance would be a global health catastrophe.

Drugs are taking longer to clear blood of malaria parasites than before.

This is an early warning sign of emerging resistance to a disease which kills a million people every year.

Until now the most effective drug cleared all malaria parasites from the blood within two or three days but in recent trials this took up to four or five days.

First Aid Instructor weekend course dates added – train to be a first aid instructor

We have now added an extra weekend dates for the core instructor and full first aid at work instructor.  You can also do the manual handling instuctor at the same time.

• Core and FAW 20-21 June
• Core and FAW  22-23 August
• Core and FAW 19-20 September
• Core and FAW 24-25 October
• Core and FAW 28-29 Nov
• Core and FAW 12-13 Dec

Full details of dates can be found at http://www.itg-first-aid.com/course_dates.htm

The Health Protection Agency said in 2008 there was an increase in cases of Lyme disease, a tick-borne infection.

It said the moors was one of several areas which tended to be more affected.

Wendy Fox, who was left paralysed after being diagnosed with Lyme disease in 1993, urged people not to take the subject lightly.

Lyme disease is an infection caused by a bacteria which is transmitted to humans by ticks that live on animals.

Most cases can be treated successfully with antibiotics but, if left untreated, it can infect the heart, joints and nervous system.

Tick prevention advice:

Keep away from long grass or overgrown vegetation if possible

Wear long trousers tucked into socks in tick-infested areas

Inspect skin frequently and remove any attached ticks

Check again at the end of the day, especially in skin folds

Check that ticks are not brought home on clothes or pets

Mrs Fox, from Wath-upon-Dearne in South Yorkshire, was bitten by ticks while working as a zoo keeper and now spends her life in a wheelchair, paralysed from the waist down.

She founded the BADA-UK charity, which was set up to raise awareness of tick-borne diseases.

Mrs Fox told BBC News: “I think people do take the subject very lightly and it’s frustrating for me and for us as a charity that people don’t take them seriously.

“The problem is that one tick is all it takes to make you sick and if you can recognise the fact that they are there and take precautions against them that’s so, so important.”

The Health Protection Agency (HPA) said ticks were small and could easily be overlooked.

Professor Mike Catchpole, from the HPA, said: “Check for attached ticks regularly and remove them promptly. Most ticks do not carry the infection and infected ticks are very unlikely to transmit the organism if they are removed within a few hours of attachment.

“The most common symptom of Lyme disease is a slowly expanding rash which spreads out from a tick bite, usually becoming noticeable after about three to fourteen days.”

Type 1 or type 2 Diabeties

Type 1: Beta cells of the pancreas no longer make the hormone insulin because the body’s immune system has attacked and destroyed them. Treatment includes taking insulin and possibly another injectable medicine

Type 2: Usually develops later in life. Often linked to lifestyle factors, such as obesity. Occurs when the pancreas does not produce enough insulin to meet the body’s needs or the insulin is not used effectively by the body’s cells. Usually treated by diet and exercise.

The number of under-fives in Europe with type 1 diabetes is set to double between 2005 and 2020, say experts.

Child diabetes cases ‘to double’

The researchers, from Ireland and Hungary, warn cases in older children will also rise substantially.

Writing in The Lancet, they say genetics alone cannot account for the rapid rise, and suggest lifestyle factors are likely to play a role.

The study is based on 29,311 cases of type 1 diabetes recorded in 20 European countries between 1989 and 2003.

Type 1 diabetes is caused by insulin deficiency, and must be treated with regular injections of the hormone.

In the general population it accounts for only 10% of total diabetes cases, but is much more common than the type 2 version in children.

The researchers, from Queen’s University, Belfast, and Pecs University, Hungary, found the overall incidence of type 1 diabetes rose by 3.9% per year.

However, among the under-fives it was 5.4% per year, and in the five to nine age group it was 4.3% per year.

They calculated that, on present trends, 24,400 new cases will be diagnosed in children under 15 in 2020, including 7,142 cases in the under-fives.

The total number of cases of type 1 diabetes among European children under 15 is predicted to rise from 93,584 in 2005 to 159,767 in 2020 – a 70% increase.

Among the under-fives, the total number of cases is predicted to double, from 9,955 in 2005 to 20,113 in 2020.

In the UK, where type 1 diabetes appears to be more common than elsewhere in Europe, the predicted rises are bigger still.

The researchers predict the total number of cases in the under-15s will rise by nearly 80% from 18,622 in 2005 to 33,289 in 2020.

And among the under-fives, they expect to see a 123% rise, from 1,975 in 2005 to 4,402 in 2020.

Lifestyle factors

The researchers say the increase in type 1 diabetes has been so rapid that it cannot be blamed on genetic factors alone.

They also point out that the highest increases have been seen in Eastern Europe, where lifestyle habits are changing more rapidly than in richer Western European nations.

Researcher Dr Chris Patterson said: “The children of older mums are at slightly increased risk of type 1 diabetes as are children born by Caesarean section and children with rapid weight gain early in life, while breast-fed children are at slightly decreased risk.

“Infections and viruses may also play a role. But currently none of these risk factors can be said to be responsible for the increase, the cause of which remains largely unknown.”

The researchers warn that it is likely that hospitals will see more patients with severe diabetes complications presenting at a younger age.

These can include the potentially life-threatening condition ketoacidosis, in which the acidity of the blood is raised by the unregulated breakdown of fats and proteins by the liver.

Not only do young children with type 1 diabetes tend to be diagnosed late, and so have a higher risk of complications, they potentially face a lifetime of problems – bad news for them, and for the health care systems who must look after them.

Writing in the journal, the researchers said: “In the absence of any effective means to prevent type 1 diabetes, European countries need to ensure appropriate planning of services and that resources are in place to provide high-quality care for the increased numbers of children who will be diagnosed with diabetes in future years.”

Dr Iain Frame, director of research at the charity Diabetes UK, described the research as “worrying”.

“Many people live full and healthy lives, however, the longer the person has diabetes the higher the risk of complications such as heart disease, kidney failure and blindness.

“However, a lot more research is needed before we can come to any concrete conclusions about the causes of this rise in type 1 diabetes in younger children.”

AED Trainer unit only £225 available from ITG First Aid Instructor

We have a new stock of AED trainer units available for delivery at just £225.  The units have remote control, 9 training options, pad and motion alerts, 2 sets child pads, 3 sets of adult pads and mains transformer.  The unit is half size so easy to transport and use and runs on 3 AA batteries or mains power and comes in a carry case.

We have found that this trainer has more features than units twice the price.

To order please email or call us on 08450 534865 or 01223 911468 or email us through the website http://www.itg-first-aid.com/index.htm or on info@itg-first-aid.com

First Aid Instructor course date added – train to be a first aid instructor

We have now added an extra date in August from the 24th to the 28th for the core instructor and full first aid at work instructor.  You can also do th emanual handling instuctor at the same time.

We have a weekend core instructor first aid course on 20th June as well in Colchester Essex.

Full details of dates can be found at http://www.itg-first-aid.com/course_dates.htm

How To Treat Dog Bites

As much as humans interact with canines, dog bites are common, especially in children. Responding to a dog bite should always start with the safety of all involved, including the victim, the rescuer, and if possible, the dog.

Full story at http://firstaid.about.com/od/bitesstings/ht/07_Dog_Bites.htm

ITG Train the Trainer Course

This course is aimed at anyone who is entering the world of instructing or who needs some new ideas to their teaching style. It is not aimed to the first aid market only as these are basic teaching skill that can be applied to any industry. The course is taught in a relaxed and informative way over two days and are held in our training rooms in Colchester, Essex in East Anglia. We also run the courses at other locations and on site subject to minimum numbers.

The course is a low price to gain the extra skills to make trainers of a higher standard.

Train The Trainer Course Objectives:

* Adapt your style and material to suit the situation

* Work with difficult situations and people

* Change tack quickly and without fuss

* Meet people’s needs and expectations

* Handle your delegates’ anxieties and nervousness

* Surprise your participants and yourself

* Make learning and development exciting and creative

The course is about developing natural talent and accepting that everyone is different and ensuring candidates adapt their style to informative teaching.

We teach all our courses in a relaxed informative way to maximise information retention and all students will receive various paper and digital information as good reference after the course.

Two day Train the Trainer Training Program:

Day one – Running the room effectively and using your Personal Style

Understanding group dynamics

Identifying your personal training style and staying true to it

Working the room

Turning the volume up and down

Setting the tone

Using anecdotes and personal stories to exemplify your training work

Knowing how to treat those in the room

Animation – knowing when to turn it up and down

Dealing with difficult participants and situations

Train The Trainer Training Day Two – Seeing

Discover your ability to actually see what’s going on in the room

‘Removing’ yourself from proceedings

Knowing your own behavior

A look at patterns and beliefs

Realising that everyone sees things differently

Seeing and dealing with sudden changes within your training environment

Recognising and dealing with potentially undermining situations

An opportunity to play out or rehearse specific scenarios

Designing a Training

Wrap up and review

Final Train the Trainer Handouts

All delegates will be issued with relevant hand-outs to remind them of the Train the Trainer Course work, including our memorable visual cue cards. Delegates will also be able to take away Impact Factory web cards, which will give them access to our extensive e-library of useful documents.

If you would like more information please email us at the above address or call us on 01223 911468 or see our train the trainer page on our website