Taking pituitary surgery as an example, a large peer-reviewed study published in January’s Clinical Endocrinology indicates that the move in the late 1990s to concentrate treatment in specialist centres has resulted in a significant increase in success rates, better outcomes for patients and potential savings for the NHS. For pituitary disease, experience is an important determinant of surgical success and patients benefit from being treated by a specialist surgeon.
Researchers, led by Prof John Wass at The Churchill Hospital, Oxford, examined which factors were important in predicting the success rates of surgery for a rare pituitary condition called acromegaly. To study this, they used data collected by the UK National Acromegaly Register, a computer database established to help research into this disease. The Register gathered information from 22 contributing centres across the UK over 30 years between 1974 and 2004. The research team analysed the records of 785 patients to work out the main factors that affect surgery success rates.
Patients receiving surgery in 2000 or later were significantly more likely to make a full recovery. Average success rates were 53% in 2000-2004 compared to 39% in 1995-1999. We know from previous work that treatment by a dedicated pituitary surgeon significantly increases the chances that surgery will be successful(1). The recent overall improvement in surgical results coincides with a national trend (from 1999 onwards) to concentrate pituitary surgery in regional centres of expertise where patients are seen by skilled surgeons with experience in treating this rare condition.
The Government is currently implementing reforms that allow patients to choose which hospital they would like to be treated in. For patients with rare/complex conditions, this initiative has the potential to allow more people to receive treatment in dedicated centres from doctors experienced in dealing with those conditions. As this study shows, for pituitary patients, this is likely to increase treatment success rates and has the potential to save the NHS £5 million a year on the treatment of acromegaly patients alone(2). Acromegaly patients, in whom pituitary surgery is not successful, undergo prolonged and expensive medical treatment to keep their growth hormone levels within the normal range. The NHS will provide free choice for patients in all specialities from April 2008.
Acromegaly is condition where the body produces too much growth hormone. It is usually caused by a tumour on the pituitary gland, a pea-sized gland found at the bottom of the brain. Symptoms include a coarsening in facial features and an enlargement of the hands and feet. This is a very rare condition, with only four to six new cases reported per million people each year. The most common treatment is surgery on the patient’s pituitary gland to remove the tumour. To find out if surgery has been successful, doctors measure the level of growth hormone in the patient’s blood to see if it has returned to normal levels.
Researcher Prof John Wass says:
“Our study shows that creating centres of expertise for treating rare diseases can have significant positive benefits for patients. Taking treatment of the pituitary disorder acromegaly as an example, we have seen a substantial increase in surgical success rates since 2000, when there was a move towards concentrating surgery in the hands of a smaller number of specialists. In cases such as these, specialist knowledge is vital and we recommend that, where possible, patients should be offered surgery by a dedicated pituitary surgeon.
Our research sheds new light on how changes in the way that patients are referred for treatment have resulted in real improvements in the level of care and recovery rates. This study shows that, for patients with rare diseases, the Government’s initiative to provide patients with greater choice is a good idea, which should lead to more patients receiving specialist treatment and will also reduce NHS spending overall.”
Jennie Evans | alfa
Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung
Scientists reveal source of human heartbeat in 3-D
07.08.2017 | University of Manchester
Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.
As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...
Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.
Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...
For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.
While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...
An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.
The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...
A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.
Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...
16.08.2017 | Event News
04.08.2017 | Event News
26.07.2017 | Event News
17.08.2017 | Physics and Astronomy
17.08.2017 | Earth Sciences
17.08.2017 | Physics and Astronomy