NICE

Consultation documents (19th February 2010 - 3rd March 2010)

NICE are now consulting on the following:

Photodynamic therapy for Barrett's oesophagus: Interventional Procedures Consultation Document - closing date 23rd March 2010

Transperineal temlate biopsy of the prostate: Interventional Procedures Consultation Document - closing date 23rd March 2010

Percutaneous occlusion of the left atrial appendage in non-valvular atrial fibrillation for the prevention of thromboembolism: Interventional Procedures Consultation Document - closing date 23rd March 2010

Extracranial to intracranial bypass for intracranial atherosclerosis: Interventional Procedures Consultation Document - closing date 23rd March 2010

Stapled transanal rectal resection for obstructed defaecation syndrome: Interventional Procedures Consultation Document - closing date 23rd March 2010

Motor neurone disease - non-invasive ventilation: draft guideline for consultation - closing date 23rd March 2010

Caesarean section (update): scope consultation - closing date 24th March 2010

PSHE: consultation on the evidence - closing date 24th March 2010

Rheumatoid arthritis - drugs for treatment after failure of a TNF inhibitor: appraisal consultation document - closing date 24th March 2010

Rheumatoid arthritis - tocilizumab: appraisal consultation 3 - closing date 25th March 2010

Leukaemia (chronic lymphocytic, relapsed) - rituximab: final appraisal determination - closing date 18th March 2010

Myelodysplastic syndromes - azacitidine: final appraisal determination - closing date 18th March 2010

Crohn's disease - infliximab (review) and adalimumab: final appraisal determination - closing date 18th March 2010

Interventional Procedures Guidance IPG333. Therapeutic endoscopic division of epidural adhesions (24th February 2010)
Endoscopic epidural procedures are used to treat lower back pain, particularly when radiculopathy is present. The epidural space is examined with an endoscope and further interventions may then be performed, such as mobilising spinal adhesions or administering drugs to inflamed tissue.
Guidance

Interventional Procedures Guidance IPG332. Surgical correction of hallux valgus using minimal access techniques (24th February 2010)

Hallux valgus is a deformity of the big toe. The big toe tilts outwards, crowding the smaller toes, and a bony lump (called a bunion) appears on the inside of the foot.

Under local or general anaesthesia, one or more small cuts are made to insert bone-cutting instruments. These are used to remove the bunion and to divide one or more of the bones of the front of the foot. The divided bones may need to be stabilised with wires, screws or plates. The aim is to correct the tilting of the big toe. The operation is monitored by X-rays or an endoscope (a telescope for looking inside the body). Compared with standard (open) surgery, this procedure uses smaller cuts to the foot and X-rays or endoscopy to see inside the foot.
Guidance

Interventional Procedure Guidance IPG331. Cytoreduction surgery followed by heyperthrmic introperative peritoneal chemotherapy for peritoneal carcinomatosis (24th February 2010)

Peritoneal metastases commonly result from the regional spread of gastrointestinal, gynaecological and other malignancies. Peritoneal carcinomatosis is an advanced form of cancer associated with short survival and poor quality of life, which may lead to bowel obstruction, ascites and pain.

This procedure was developed by Paul Sugarbaker at the Washington Cancer Institute. A laparotomy is performed under general anaesthesia and all gross tumour is removed along with the involved organs, peritoneum and tissue. The surgery includes:

• removal of the right hemicolon, spleen, gall bladder, parts of the stomach, greater omentum and lesser omentum
• stripping of the peritoneum from the pelvis and diaphragm
• stripping of tumour from the surface of the liver
• removal of the uterus and ovaries in women
• removal of the rectum in some cases.

Guidance

Technology Appraisal Guidance TA185. Trabectedin for the treatment of advanced soft tissue sarcoma (24th February 2010)

Trabectedin is recommended as a possible treatment for people with advanced soft tissue sarcoma if:

• treatment with anthracyclines and ifosfamide has failed, or
• they cannot tolerate anthracyclines and ifosfamide, or
• anthracyclines and ifosfamide are unsuitable.

The manufacturer of trabectedin has agreed to a 'patient access scheme', which means that when a person needs more than five trabectedin treatments, it provides the sixth and any further trabectedin treatments to the NHS free of charge.
Guidance

Technology Appraisal Guidance TA186. Certolizumab pegol for the treatment of rheumatoid arthritis (24th February 2010)

Certolizumab pegol is recommended as a possible treatment for people with rheumatoid arthritis who:

• have already tried methotrexate and another disease-modifying anti-rheumatic drug (DMARD), usually for at least 6 months,and
• have severe 'active' rheumatoid arthritis, as assessed by arheumatologist on two separate occasions

People who are treated with certolizumab pegol should normally also be given methotrexate. If methotrexate does not suit them, they may be given certolizumab pegol on its own.
Guidance

Clinical Guidelines CG93. Donor breast milk banks: the operation of donor breast milk bank services (24th February 2010)

The advice in the NICE guideline covers:

• How milk banks should recruit, screen and support women who donate breast milk
• How milk banks should handle and process the breast milk they receive from donors.

It does not specifically look at:

• How donated breast milk is used after it leaves the milk bank
• The care and treatment of babies who receive donated breast milk
• How mothers should handle and store breast milk for their own babies.

Guidelines

Public Health Guidance PG23. School-based interventions to prevent the uptake of smoking among children (24th February 2010)

This guidance is for all those responsible for preventing the uptake of smoking by children and young people aged under 19. This includes those working in the NHS, local authorities, education and the wider public, private, voluntary and community sectors. It may also be of interest to children and young people, their parents or carers and other members of the public.

The five recommendations include the following advice:

• The smoking policy should support both prevention and stop smoking activities and should apply to everyone using the premises (including the grounds).
• Information on smoking should be integrated into the curriculum. For example, classroom discussions could be relevant when teaching biology, chemistry, citizenship and maths.
• Anti-smoking activities should be delivered as part of personal, social, health and economic (PHSE) and other activities related to Healthy Schools or Healthy Further Education status.
• Anti-smoking activities should aim to develop decision-making skills and include strategies for enhancing self-esteem. Parents and carers should be encouraged to get involved and students could be trained to lead some of these programmes.
• All staff involved in smoking prevention should be trained to do so.
• Educational establishments should work in partnership with outside agencies to design, deliver, monitor and evaluate smoking prevention activities.

Guidance