Is there a role for routine chest X-ray in diagnosing metastatic disease in invasive breast cancer patients?
Guidance by topic: the following guidance topics matching your health area preferences have been published or updated
- Acute coronary syndrome – rivaroxaban [ID532]
- Antenatal and postnatal mental health (update)
- Antenatal care
- Arrythmias – ICDs & Heart failure – cardiac resynchronisation [ID481]
- Arthritis of the hip (end stage) – hip replacement (total) and resurfacing arthroplasty (Rev TA2, TA44) [ID540]
- Asthma – diagnosis and monitoring
- Atrial fibrillation (stroke prevention) – rivaroxaban
- Atrial fibrillation – dabigatran etexilate
- BMI and waist circumference – black, Asian and minority ethnic groups
- Breast cancer (HER2 negative, oestrogen receptor positive, locally advanced or metastatic) – everolimus (with an aromatase inhibitor) [ID538]
- Colorectal cancer (metastatic) – regorafenib [ID593]
- EXOGEN ultrasound bone healing system for long bone fractures with non-union or delayed healing
- Familial breast cancer
- Gene expression profiling and expanded immunohistochemistry tests to guide the use of adjuvant chemotherapy in early breast cancer management: MammaPrint, Oncotype DX, IHC4 and Mammostrat
- Intrapartum care
- Lung cancer (non-small-cell, anaplastic lymphoma kinase fusion gene, previously treated) – crizotinib [ID499]
- Mega Soft Patient Return Electrode for use during monopolar electrosurgery
- Multiple myeloma – bortezomib (induction therapy) [ID610]
- Non Hodgkin’s lymphoma (relapsed refractory) – pixantrone monotherapy [ID414]
- Prostate cancer (hormone relapsed, metastatic) – enzalutamide (after docetaxel)
- Psoriatic arthritis (active, progressive) – ustekinumab [ID607]
- Pulmonary embolism (acute treatment, VTE prevention) – rivaroxaban [ID569]
- Pulmonary embolism and recurrent venous thromboembolism – rivaroxaban
- Self-monitoring coagulometers (CoaguChek XS system, INRatio2 PT/INR monitor and ProTime Microcoagulation system), for self-testing or self-managing coagulation status in people for whom long-term vitamin K antagonist therapy is intended.
- Systemic lupus erythematosus (autoantibody-positive) – belimumab [ID416]
- Tuberculosis (update)
- Ulcerative colitis
- WatchBP Home A for opportunistically detecting atrial fibrillation during diagnosis and monitoring of hypertension
More treatments for women at risk of breast cancer
Updated guidance from NICE gives more options to women to reduce their risk of breast cancer. NICE recommends tamoxifen or raloxifene as preventative treatments for certain women at high risk of breast cancer due to a family history.
Nicotine products can help people to cut down before quitting smoking
Licensed nicotine products, such as patches and gum, should be offered to people who smoke and are struggling to quit to help them cut down on cigarettes, NICE says. NICE recommends that stop smoking advisers and health professionals advise people to stop smoking in one go, but for those who aren’t ready or are unable to stop in one step, they should suggest considering a harm-reduction approach.
Offer range of effective treatments for people with hep B
More people with hepatitis B should be assessed, referred and offered the range of clinical and cost effective treatments available for the disease, according to NICE. In its first clinical guideline on hepatitis B, NICE recommends a range of measures to help raise awareness of the condition and reduce the current variation in treatments offered.
Older patients at high risk of hospital falls
Updated guidelines from NICE recommend that healthcare professionals should consider patients aged 65 or older, and those aged over 50 with underlying conditions such as stroke, at high risk of falling while in hospital care.
Podcasts available on falls and antisocial behaviour and conduct disorders
Let us know what you think of our draft guidance on behaviour change. The behaviours covered are alcohol, diet, physical activity, sexual behaviour and smoking, and the consultation closes on 31 July 2013.
We’d also like to hear your thoughts on our draft update of our guideline on neuropathic pain. Neuropathic pain is pain caused by a lesion or disease of the central somatosensory nervous system. The consultation closes on 18 July 2013.
An interesting case of screen-detected breast cancer encasing a ventriculoperitoneal shunt was published recently in BMJ Case Reports, 2013, 1757-790X (2013)
Abstract: A 67-year-old woman was diagnosed with a breast cancer via screening encasing the ventriculoperitoneal shunt. Triple assessment including MRI scan of the breast confirmed the presence of a breast mass and the tubing of the ventriculoperitoneal shunt was running directly through the mass. She underwent wide local excision of the breast cancer as well as rerouting of VP shunt as a joint procedure with the neurosurgery team and recovered uneventfully. This is a very rare and an interesting case and required management involving a different specialty.
17.10 The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients (Roberts)
17.09 A systematic review and economic evaluation of new-generation computed tomography scanners for imaging in coronary artery disease and congenital heart disease: Somatom Definition Flash, Aquilion ONE, Brilliance iCT and Discovery CT750 HD (Westwood)
17.07 Study of the use of antidepressants for depression in dementia: the HTA -SADD trial – a multicentre, randomised, double-blind, placebo-controlled trial of the clinical effectiveness and cost-effectiveness of sertraline and mirtazapine (Banerjee)
The National Institute for Health and Clinical Excellence (NICE) is currently in the process of updating its clinical guideline on familial breast cancer[i]. Today (15 January), NICE has begun a consultation on a draft version of the guideline with new, provisional recommendations relating to genetic testing[ii], screening and the use of preventive treatments. The draft update also, for the first time, makes recommendations for people with a recent diagnosis of breast cancer who also have a family history of the disease.