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Aim: To investigate the frequency and characteristics of adverse drug reactions (ADRs) in hospitalised neonates to obtain a better understanding of and improvement in neonatal healthcare.Methodology: A prospective cohort study. Data were collected on 313 neonates and 2166 drug prescriptions. Clinical characteristics of patients, drugs administered and ADRs were prospectively recorded and analysed. Informed consent was obtained in all cases.Results: 116 different ADRs were detected. 17% of the neonates experienced at least one of these ADRs. Systemic antimicrobials and caffeine citrate were the drugs that most commonly caused ADRs. According to the ADR Severity Assessment Scale, 41% were mild, 42% were moderate and 17% were severe. Of the ADRs identified, 11% were classified as 'certain' by the Naranjo method and 20% were classified as 'defined' by the Karch and Lasagna modified algorithm. Most of the ADRs detected were related to feed intolerance, phlebitis and tachycardia. Most were acute (73%) and lasted between 1 and 7 days (39%). After the occurrence of an ADR, it was necessary to initiate specific treatment in 44 cases, discontinue the drugs involved in 30 cases, and reduce the drug dose in another 30 cases. An association was shown between the number of drugs prescribed and ADR onset.Conclusions: There is a high incidence of ADRs in hospitalised newborns, which increases with the number of prescriptions. [ABSTRACT FROM AUTHOR]

Background: Short-course oral corticosteroids are commonly used in children but are known to be associated with adverse drug reactions (ADRs). This review aimed to identify the most common and serious ADRs and to determine their relative risk levels.Methods: A literature search of EMBASE, MEDLINE, International Pharmaceutical Abstracts, CINAHL, Cochrane Library and PubMed was performed with no language restrictions to identify studies in which oral corticosteroids were administered to patients aged 28 days to 18 years of age for up to and including 14 days of treatment. Each database was searched from their earliest dates to December 2013. All studies providing clear information on ADRs were included.Results: Thirty-eight studies including 22 randomised controlled trials (RCTs) met the inclusion criteria. The studies involved a total of 3200 children in whom 850 ADRs were reported. The three most frequent ADRs were vomiting, behavioural changes and sleep disturbance, with respective incidence rates of 5.4%, 4.7% and 4.3% of patients assessed for these ADRs. Infection was one of the most serious ADRs; one child died after contracting varicella zoster. When measured, 144 of 369 patients showed increased blood pressure; 21 of 75 patients showed weight gain; and biochemical hypothalamic-pituitary-adrenal axis suppression was detected in 43 of 53 patients.Conclusions: Vomiting, behavioural changes and sleep disturbance were the most frequent ADRs seen when short-course oral corticosteroids were given to children. Increased susceptibility to infection was the most serious ADR.Trial Registration Number: CRD42014008774. By PROSPERO International prospective register of systematic reviews. [ABSTRACT FROM AUTHOR]

Background: In Africa, fewer than half of patients receiving therapy for multidrug-resistant TB (MDR TB) are successfully treated, with poor outcomes reported for HIV-coinfected patients.Methods: A standardised second-line drug (SLD) regimen was used in a non-governmental organisation-Ministry of Health (NGO-MOH) collaborative community and hospital-based programme in Ethiopia that included intensive side effect monitoring, adherence strategies and nutritional supplementation. Clinical outcomes for patients with at least 24 months of follow-up were reviewed and predictors of treatment failure or death were evaluated by Cox proportional hazards models.Results: From February 2009 to December 2014, 1044 patients were initiated on SLD. 612 patients with confirmed or presumed MDR TB had ≥ 24 months of follow-up, 551 (90.0%) were confirmed and 61 (10.0%) were suspected MDR TB cases. 603 (98.5%) had prior TB treatment, 133 (21.7%) were HIV coinfected and median body mass index (BMI) was 16.6. Composite treatment success was 78.6% with 396 (64.7%) cured, 85 (13.9%) who completed treatment, 10 (1.6%) who failed, 85 (13.9%) who died and 36 (5.9%) who were lost to follow-up. HIV coinfection (adjusted HR (AHR): 2.60, p<0.001), BMI (AHR 0.88/kg/m(2), p=0.006) and cor pulmonale (AHR 3.61, p=0.003) and confirmed MDR TB (AHR 0.50, p=0.026) were predictive of treatment failure or death.Conclusions: We report from Ethiopia the highest MDR TB treatment success outcomes so far achieved in Africa, in a setting with severe resource constraints and patients with advanced disease. Intensive treatment of adverse effects, nutritional supplementation, adherence interventions and NGO-MOH collaboration were key strategies contributing to success. We argue these approaches should be routinely incorporated into programmes. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the incidence of adverse drug reactions (ADRs) in children in Camagüey Province, Cuba. METHODS: A national pharmacovigilance programme has been established in Cuba and involves suspected ADRs being reported to provinces. All suspected ADRs reported to Camagüey Province during 2008 were analysed and classified in relation to causality and severity. RESULTS: Over a 12-month period, there were 124 reports of 152 suspected ADRs in children. Most ADRs were mild (98, 79%), but two were fatal and five others were severe. Antibiotics were the group of medicines most likely to be associated with ADRs. The overall report rate of suspected ADRs was 634 per million children per year, which is considerably higher than previously reported rates. CONCLUSIONS: ADRs in children are more frequent than previously reported. A successful pharmacovigilance programme can be established in lower middle income countries. [ABSTRACT FROM AUTHOR]

Objective To investigate: (1) the feasibility of establishing active paediatric surveillance for adverse drug reactions (ADRs), (2) whether electronic reporting is effective and (3) whether such a system could complement the Medicines and Healthcare products Regulatory Agency (MHRA) yellow card system. Design Between January 2006 and February 2007 ADRs in children under 16 were reported each month by consultant paediatricians and paediatric pharmacists in Scotland. For 8 months respondents received a postal card, after which half were selected to report electronically via an email card for a further 6 months and half continued with the postal card. Reports of paediatric ADRs severe enough to warrant hospital admission or to delay discharge of hospitalised patients or resulting from an outpatient prescription were followed up. A postal questionnaire evaluated the system at the end of the study. Results Following a 2-month lead-in period, 83% of the cards were returned over the year, 84% by paediatricians and 82% by pharmacists. With electronic reporting the response rate was 80%. Eighty-seven confirmed reports of a drug being associated with one or more adverse reactions were reported in 67 children. Only eight children were also identified through the MHRA yellow card system. Respondents indicated continuing willingness to contribute to an active (preferably electronic) reporting system. Conclusions Active paediatric ADR surveillance is feasible; electronic reporting is effective and data collected are different to, but could complement, those collected by the MHRA yellow card. [ABSTRACT FROM AUTHOR]

Background The possible role of leukotriene receptor antagonist (LTRA) therapy in the pathogenesis of Churg- Strauss syndrome (CSS) is uncertain. The aim was to examine the association between LTRA therapy and CSS in cases registered in the FDA Adverse Event Reporting System (AERS) database. Methods All cases of suspected drug-induced CSS reported to the AERS database between November 1997 and April 2003 were reviewed. Subjects in whom LTRAs were the suspected medication and sufficient documentation existed to confirm the diagnosis of CSS were sequentially categorised into one of the following groups: (A) CSS before treatment initiation; (B) oral or inhaled corticosteroids reduced or stopped within 6 months of CSS onset; (C) possible prodromal phase of CSS at treatment initiation; (D) unstable asthma at treatment initiation; (E) stable asthma at treatment initiation. Results There were 181 case reports of suspected druginduced CSS with sufficient documentation to confirm a diagnosis of CSS; in 163 (90%) an LTRA was a suspect medication. In 140 of these 163 cases there was sufficient documentation to sequentially categorise the case into groups, with 13 (9%) in A, 27 (19%) in B, 11 (8%) in C, 28 (20%) in D and 61 (44%) in E. Conclusion LTRA therapy was a suspect medication in most confirmed cases of CSS reported in the AERS database. In the majority of cases treated with an LTRA, CSS could not be explained by either corticosteroid withdrawal or pre-existing CSS. These findings are informative in considering the potential associations between LTRA therapy and CSS. [ABSTRACT FROM AUTHOR]

BACKGROUND/AIMS: To compare the intraocular pressure (IOP) lowering efficacy and side effects of latanoprost 0.005% and bimatoprost 0.03% in subjects with chronic primary angle closure glaucoma (PACG). METHODS: This was an observer-masked randomised crossover study of 60 PACG subjects who received either latanoprost or bimatoprost for 6 weeks, after which they were crossed over to the other medication for another 6 weeks. The IOP-reducing effect of the medications was assessed by the reduction in IOP after 6 weeks of treatment compared with baseline. RESULTS: Fifty-four subjects (80 eyes) completed the study. Latanoprost reduced IOP (mean (SD)) by 8.4 (3.8) mm Hg and bimatoprost by 8.9 (3.9) mm Hg from a baseline of 25.2 (3.6) mm Hg and 25.2 (3.6) mm Hg respectively (p = 0.23). Adverse events were mild in both groups; however there were twice as many reports of an adverse event in the bimatoprost group (81%) compared with the latanoprost group (40%, p<0.01). Ocular irritation was the most frequently reported adverse event in both groups; 22 subjects (37.9%) treated with bimatoprost experienced ocular hyperaemia as compared with 13 subjects (22.4%) treated with latanoprost (p = 0.11). CONCLUSIONS: Bimatoprost once daily was similarly effective in reducing IOP compared with latanoprost once daily in subjects with chronic PACG. Both drugs were well tolerated with mild ocular adverse events. [ABSTRACT FROM AUTHOR]

Objective To determine whether anecdotal reports of suspected adverse drug reactions are valuable early warning signals. Design Systematic literature survey Data sources We evaluated all case reports of adverse drug reactions published in 1997 in five medical journals. Reports were excluded if the adverse reaction had previously been described in earlier publications and was already listed in the product information of the drug reference source (the British National Formulary (BNF) or the Medicines Compendium). We used the Web of Knowledge Citation Index and Medline for 2003 to identify follow-up studies. Main outcome measures Primary: the number of suspected adverse reactions subjected to formal validation studies and the findings of these studies. Secondary: the number of instances in which the warning from the case report was incorporated into the product information. Results We evaluated 63 suspected adverse reactions and found that most (52/63, 83%) had not yet been subjected to further detailed evaluation. Data from controlled studies that supported the postulated link between the drug and the adverse event were available in only three cases. Of the 48 agents listed in the drug reference sources, details of the suspected reaction were subsequently added to the Medicines Compendium in 15 instances, and to the BNF in seven instances. In each case, only one reaction had been confirmed. Conclusions Published case reports of suspected adverse reactions are of limited value as suspicions are seldom subjected to confirmatory investigation. Furthermore, these alerts are not incorporated into drug reference sources in a systematic manner. [ABSTRACT FROM AUTHOR]

This article presents an analysis of guidelines for reporting observational studies in epidemiology written by an international group of methodologists, researchers and medical journal editors in the STROBE study. Medical research relies on observational studies. They are especially useful in detecting late adverse reactions to treatments but poor reporting of this research puts the results in question. The STROBE checklist is presented to help researchers put their information into a uniform system that will be easily understood by all. Separate versions of the checklist for cohort, case-control and cross-sectional studies are available at www.strobe-statement.org.

The article addresses whether some reportings of drug reactions need to be proved by further testing. The authors argue that some adverse drug reactions are so convincing that they do not require clinical trials. They identify four types of adverse events for which further testing is unnecessary, including tissue deposition of the drug or a metabolite, specific anatomical location, and physicochemical testing. INSET: Summary points.

The authors commend the decision of the British Medicines and Healthcare products Regulatory Agency (MHRA) to ask for all suspected adverse drug reactions (ADR) in patients aged under 18 years to be reported. Topics discussed include the establishment of the world's first spontaneous reporting schemes for collecting suspected ADR in 1964, barriers to reporting using spontaneous reporting schemes, and the role of the MHRA advice in the improvement of the quality and quantity of reports.

The article reports on issues raised by medical and consumer organizations over plans by the European Commission (EC) to allow pharmaceutical companies to provide information on “prescription only drugs” directly to the public. Reaction to the measure at a conference in Brussels, Belgium organized by the Organisation for Professionals in Regulatory Affairs and the EC is discussed. Some argued that health care professionals should remain the primary source of health information for patients.

The article presents news items related to medicine. Research reported in the "Journal of the American Medical Association" found that people who survive cancer are more likely to be unemployed than people without a history of cancer. Research in the "Journal of the American Medical Association" suggests that monoclonal antibodies that are used to treat rheumatoid arthritis may be linked to the development of herpes zoster. Research in the "New England Journal of Medicine" suggests that the use of late percutaneous coronary intervention is expensive and does not improve the quality of life of patients with heart disease.

The article reports on a research paper that was featured in "Clinical Infectious Diseases". Researchers involved in the paper indicated that they had found that adverse events related to the use of antibiotics result in more than 142,000 visits peer year to hospital emergency rooms in the United States. The paper also concluded that antibiotics were implicated in 19% of all emergency room visits for drug related adverse events, and that with every 100,000 outpatient prescriptions for antibiotics there were 10.5 emergency room visits.

In 2006, levetiracetam was approved as the first of the newer anticonvulsive drugs as an intravenous formulation (ivLEV) for patients with epileptic seizures who are unable to take oral medication. We report our experience with the use of ivLEV for the treatment of 18 episodes of benzodiazepine refractory focal status epilepticus (SE) in 16 patients, including four patients with secondary generalised SE. SE was controlled in all patients by the given combination of drugs; application of further antiepileptic medications after ivLEV was necessary in two episodes. No severe side effects occurred. Our data suggest that ivLEV may be an alternative for the treatment of SE in the future, even in patients that did not respond to benzodiazepines. A large prospective, randomised, controlled study is warranted to investigate the efficacy and safety of ivLEV for the treatment of SE. [ABSTRACT FROM AUTHOR]

The article reports on a decision from 94% of patients suing Merck to accept a settlement agreement which the company offered to them. The litigants sued Merck as a result of developing side effects from the company's drug Vioxx. Merck announced the $4.98 billion settlement in November of 2007, and indicated that individual awards contained within it would range on average from $150,000 to $200,000. To receive the awards litigants must provide evidence of a Vioxx related heart attack or stroke, proof that they received at least thirty Vioxx pills, and evidence that they took at least one pill prior to their medical event.

The article presents news items related to medicine. Research reported in the periodical "Lancet" found that the antiobesity drug rimonabant has been linked to anxiety and depression in its users. Research found in the "Journal of the American Medical Association" indicated that the the mental health of soldiers returning from Iraq deteriorates for months following their return to the U.S. from Iraq. Data from the U.S. Centers for Disease Control and Prevention reported in the "Journal of the American Medical Association" indicates that the incidence of many infectious diseases has fallen to a record low in the U.S. because of vaccination programs for infants and children.

This article presents an editorial on the use of the flu treatment drug Tamiflu and a resulting neuropsychiatric disturbance in adolescents. In March 2007 Japanese authorities advised against giving Tamiflu to teens after two suicides. No action has been taken in Europe or the U.S. because the case against the drug has not been clearly been made. However, the author urges physicians to use the drug only in patients with high risk of complications after the flu and not for otherwise healthy individuals.

The article states that the U.S. Food and Drug Administration (FDA) has announced its plans to increase regulations on the safety of new prescription drugs. The FDA has plans to more closely monitor side effects of drugs after they have been approved and put on the market. A pilot program will issue reports of new drugs 18 months after they have been on the market and will review side effects, use, and research on the drugs. It is also reported that Senator Edward Kennedy and law maker Mike Enzi introduced a drug safety bill that would require pharmaceutical companies to release their clinical trial studies and create stricter rules for the advertising of drugs.

Editorial. Presents an editorial on the appropriate strategies to collect and communicate information about harms in medicine. Report that prescribing a drug represents a trade-off between its benefits and harms; Report that approximately five percent of all admissions to U.S. and European hospitals are due to adverse drug reactions; Systems that monitor drug safety; Improvements being made to enable earlier detection of safety signals in databases of information on health care.

Comments on the reporting of adverse event monitoring in Great Britain. Aims of the post-marketing `green form' scheme; Significance of the collected data.

Presents a study on the early detection of known and unknown adverse drug reactions. Incidence of patient and doctor reporting of drug side effects; Impact on pharmacovigilance.

A letter to the editor is presented about the International Society for Pharmacoepidemiology (ISPE) and the International Society of Pharmacovigilance (ISoP) released guidelines for publishing case reports on adverse drug reactions (ADRs).

The article reports on a review of drug incidents throughout the National Health Service (NHS) in England and Wales which showed an increase in the number of reports of adverse incidents involving drugs. A significant increase in the reporting of drug incidents to the National Reporting and Learning Service (NRLS) was found by the National Patient Safety Agency (NPSA) from 64,678 incidents in 2006 to 86,085 in 2007. The authors of the report suggested that the NHS has improved its reporting culture.

The article offers several news briefs related to the field of medicine. A report by the National Secular Society estimates that chaplaincy services cost the National Health Service in Great Britain £40 million annually. Nearly a third of women who gave birth in German hospitals had caesarean sections in 2007. A regulatory agency warns of the dangers of a product called "jia hi jian" that is promoted as an "herbal" Viagra.

The article presents news items related to medicine. The National Agency for Food and Drug Administration and Control in Nigeria announced in 2009 that 84 children have died and 27 others have become ill since November of 2008 from taking a pain relief syrup called My Pikin. The Global Alliance for Vaccines and Immunization has announced that it will make the human papillomavirus vaccine against cervical cancer available to girls in developing nations if it can find $4 billion in funding.

The article reports on a decision of a U.S. federal judge in Illinois to reject a bid from the pharmaceutical firm Pfizer to force two leading medical journals to hand over confidential documents relating to peer reviews which were conducted on studies of the firm's drugs Bextra and Celebrex. The pharmaceutical firm had sought the documents from the "Journal of the American Medical Association" and the "Archives of Internal Medicine" in an effort to defend itself in 3,000 product liability lawsuits which had been launched over the alleged side effects of the two drugs.

The author reflects on Great Britain's plans to legally close a loophole which allowed the pharmaceutical firm GlaxoSmithKline to avoid prosecution despite the fact that increased suicide rates in children with depression were linked to the company's drug seroxat. He suggests that the decision is a good one but that it does not go far enough to solve the problem of corrupt practices in the industry. He argues that full mandatory disclosure from clinical data trials will solve the problem.

The article reports on pharmaceutical company Pfizer's decision to issue subpoenas against several medical journals, including the "British Medical Journal" and the "New England Journal of Medicine". The subpoenas were issued in an attempt to force the journals to divulge the identities and comments of peer reviewers who judged article about two of their drugs; Celebrex and Bextra. Pfizer felt that the subpoenas would help them in a legal battle which centers on claims for damages which were lodged by users of the drugs.

The article focuses on a two part television drama called "Contergan" which focuses on the thalidomide drug tragedy of Germany which began in 1957 and highlights the fate of 2,700 survivors of the tragedy. A discussion of the role Sebstian Wirtz, the chief executive officer of the German pharmaceutical firm Grünenthal, the manufacturer of thalidomide, played in attempting to get the film's broadcast stopped is presented. Arguments which the executive made which resulted in changes being made to the drama before its release are discussed. The history of the thalidomide tragedy is examined.

The article presents news items related to medicine. Great Britain's Medicines and Healthcare Products Regulatory Agency has stopped sales of the drug lumiracoxib because of an associated risk of serious liver problems. GlaxoSmithKline has upgraded the information in its warning box on the diabetes drug rosiglitazone. The government of China has received a pledge of $50 million from the Bill and Melinda Gates Foundation to help it aid organizations increase access to HIV prevention among people in high risk groups and to combat discrimination against HIV positive people.

This article looks at the use of yellow card data used to report suspected drug reactions in patients in Great Britain. The Medicines and Healthcare Products Regulatory Agency is calling for researchers to make use of the cards in their research. The agency explains why some applications for yellow card information are rejected. Most users of the database are medical researchers. Critics of the yellow card system say the information provided is too brief and because it is anonymous, it is impossible to get the full story which makes it of limited value.

This article reports that the number of reported serious adverse effects from drugs more than doubled in the U.S. from 1998 to 2005 according to a study from North Carolina. The number of deaths relating to drugs nearly tripled during the same time period according to data taken from the U.S. Food & Drug Administration's (FDA) adverse event reporting system. The study found that the number of serious events grew four times faster than the number of prescriptions given out. A small number of drugs were responsible for the higher rates reported but medical devices accounted for a strong percentage of adverse outcomes. Oxycondone and fentanyl topped the list of drugs associated with death.

This article reports on a caution issued by the Canadian Medical Association (CMA) on the off-label use of erythropoietin to treat anaemia in critically ill patients. The CMA says the caution is based on a meta-analysis in its journal which suggests that treatment of patients on dialysis, those who have undergone major surgery and those in chemotherapy for cancer, will not have an improved outcome from the drug and could even experience thrombotic complications. The report says the most treatment will save in expense is less than a unit of blood.

This editorial comments on the efforts to make sure resource poor countries get the medicines they need but caution that the programs do not have processes for monitoring drug safety in these populations. Although many of the drugs have been used in developed countries that is no guarantee they will work the same in the developing population. The author calls for the help of private groups to monitor the drugs used by reporting side effects to the World Health Organization.

This article reports that Australia has pulled the Novartis made drug called Prexige which is a cyclooxygenase-2 (Cox-2) inhibitor for the treatment of osteoarthritis after 8 cases of serious liver side effects including two deaths. The Therapeutic Goods Administration had approved the 200 milligram and 400 milligram a day doses in July 2004 based on clinical trial data available at the time. The National Prescribing Service, an independent reviewer of drug performance in Australia, cautioned that the long term safety of the drug was unknown. It appears that the high doses of the drug were responsible for the severity of the liver damage. The medication is approved in Great Britain and Canada at 100 milligram doses.

This article reports that the U.S. Food and Drug Administration (FDA) has asked the makers of two diabetes treatment drugs to put "black box" warning labels on their products. Avandia, made by GlaxoSmithKline, and Actos, made by Takeda, are the products and the new labels warn of increased risk of congestive heart failure. The labels have been requested following an article and editorial in the "New England Journal of Medicine." At a hearing on Capitol Hill in Washington, D.C., John Buse, the president of the American Diabetes Association, said SmithKlineBeecham tried to intimidate him when he spoke of his concerns about their drug.

This article reports on a drug safety system set up by Charles Bennett and colleagues at Northwestern University Feinberg School of Medicine in Chicago. The new approach to pharmacovigilance can identify adverse drug reactions up to 6 years before the U.S. Food and Drug Administration or monitoring programs run by the drug industry can. The project, named RADAR, is based on considering whether there is a theoretical reason why a drug might have a side effect. The group has no ties with pharmaceutical companies.

This article reports on possible side effects of the drug Gardasil which is the vaccine for human papillomavirus being suggested for mass inoculation of young women around the world to prevent certain types of cervical cancer. The U.S. and Australia are reporting a number of adverse reactions in some of the recipients. Three girls, who died shortly after immunization in the U.S., are believed to have had histories of clotting and heart problems. In Australia, school girls getting their first dose reported headache, nausea and dizziness.

This article reports on the findings of a meta-analysis of 42 trials on the use of the drug Avandia which was published in the "New England Journal of Medicine." The analysis found that the diabetes drug rosiglitazone has shown an increased risk of myocardial infarction and an increase in cardiovascular deaths that did not quite reach statistical significance. Details of the study are presented. The U.S. Food and Drug Administration responded to the study by posting a safety alert on its website. Drug maker GlaxoSmithKline says it strongly disagrees with the findings.

This article presents information from other general journals. Summaries on several articles are offered including on adding exenatide thiazolidinediones in type 2 diabetes. This study looked at the effects of adding exenatide to thiazolidinedisones with or without metformin. The study showed that after 16 weeks those getting the exenatide injections twice daily had lower glycated hemoglobin, serum fasting glucose and body weight than the control group although many dropped out of the study due to nausea and vomiting. In a different publication the study of sumatriptan-naproxen for migraines was examined where it was found to be more effective than placebo for headache relief. A routine breast cancer screening study showed the risks for women in their 40s to be considerable.

The article presents news items related to medicine. An independent public inquiry has been set up to examine how thousands of people with hemophilia became infected with HIV and hepatitis C after receiving tainted blood in Great Britain. U.S. federal court judge Jack Weinstein has said that eight defendants must return Eli Lilly documents on the marketing and side effects of olanapine. A much disputed German healthcare reform bill was passed in March 2007 after having received approval from representatives of Germany's 16 states.

The author reports that alleged illegal practices in the marketing of the drug Zyprexa threaten the drug company, Eli Lilly, with lawsuits from U.S. state governments. Zyprexa is used in the treatment of schizophrenia and bipolar disorder. The company allegedly concealed information about serious adverse effects from the drug.

The article discusses a report by the British Medical Association which found that more than a quarter of a million people are admitted to hospitals in Great Britain as a result of adverse effects after taking drugs. The study found that the drugs most often involved in the cases were aspirin, diuretics, warfarin and non-steroidal anti-inflammatories. In Great Britain, adverse effects must be reported to the Medicines and Healthcare Products Regulatory Agency, but the scheme is voluntary and the number of reported cases has not changed in the past 20 years. The report emphasized the importance of health professionals considering it their duty to report such cases.

A letter to the editor is presented in response to "Case reports of suspected adverse drug reactions--systematic literature survey of follow-up," from the February 11, 2006 issue of the British Medical Journal.

A letter to the editor is presented in response to "Case reports of suspected adverse drug reactions--systematic literature survey of follow-up," from the February 11, 2006 issue of the British Medical Journal.

This article discusses the suspension of Abbott Laboratories from its trade organization for bribing doctors. Abbott managers admitted to providing senior hospital personal with tickets to the Wimbledon tennis tournament, trips to greyhound racing parks, and even strip clubs. The Association of the British Pharmaceutical Industry blamed Abbott for discrediting the pharmaceutical industry, but had faced similar problems when, in 2005, drug companies were convicted of downplaying the serious side-effects of their drugs. The health-care professional who accepted the gifts were also focused upon, further confirming the strong influence pharmaceutical companies have on influencing doctor's decisions.

States pharmaceutical companies might be manipulating reports of adverse reactions to generic drugs that are competing with their brand-name products. View of the World Health Organization's Uppsala Monitoring Centre that monitoring systems could be vulnerable to manipulation; The number of "suspicious" reports spotted by Poland's Office of Medicinal Products, Medical Devices and Biocides; Why the WHO center wants the regulator to investigate; View of Professor Ralph Edwards, director of the WHO centre, that pharmocovigilance centers can spot these trends.

Presents medical news briefs which discuss several issues including: the plan to offer cheap, fixed dose treatments for malaria, Reaction of US doctors to watchdog groups, warnings given regarding food and drug interactions, and reports of a third death in Cambodia due to avian flu.

Describes the author's idiosyncratic reaction to an antibiotic, which took the form of black hallucinations. Idea that adverse effects could be detected earlier if they were logged by the Medicines Control Agency in their common descriptive language rather than in medical terms; Suggestion that a Database of Unlikely Sensations in Takers of Medicines be set up.