Health News

Cancer nurses funding row

February 8, 2010 – 8:00 pm

Adam Brimelow
Health Correspondent, BBC News

Gordon Brown has given more details of Labour’s plans to provide dedicated one-to-one specialist nursing for everyone in England with cancer.

In a speech in central London the prime minister said the move would transform the experience of patients.

The Conservatives and Liberal Democrats say the government is not being honest about funding the extra nurses.

But senior health officials say the move could mean savings from reduced hospital admissions.

"Too many cancer patients and cancer survivors do not get the right support to meet their varied needs."

Ciaran Devane, Macmillan Cancer Support

In a speech at the health research charity, The King’s Fund, Gordon Brown outlined his thoughts on the future of the NHS.

"We must push forward with new and ever more stretching guarantees to secure for every family the right to get the best possible personalised health care when and where they need it," he said.

Enforceable

He confirmed that the guarantees would be legally enforceable.

They include the right for anyone with suspected cancer to see a specialist within two weeks of diagnosis, and a commitment to ensure that all cancer tests will be completed and results given in one week.

Mr Brown said one-to-one specialist care at home for cancer patients could "transform their experience", and would benefit 1.6 million people.

Under the plan the specialist nurses would support patients during treatment and beyond, helping to deal with side-effects and keeping an eye out for signs of a relapse.

The department of health in England says £20 million pounds has been set aside for the first twelve months of the five-year programme.

But officials could not confirm how it will be paid for after that.

Questions

In response, the Conservatives and Liberal Democrats have praised the work of cancer nurses, but questioned how the plan could be delivered.

The shadow health secretary, Andrew Lansley, said: "I’m worried that they are not being straight with the public.

"It is very difficult to see how they will be able to fund their pledge for one-to-one nursing."

For the Liberal Democrats, Norman Lamb acknowledged the plan was an "attractive proposition", but he questioned the Prime Minister’s motives.

He said: "The obvious question is has it been properly thought through and how exactly will it be funded

"With only months until an election must be called this reeks of yet another desperate pre-election bribe by Labour."

The government intends to work closely with the charity Macmillan Cancer Support in providing the extra nurses.

The charity’s Chief Executive, Ciaran Devane, praised the plan saying: "This is very welcome news. Macmillan is delighted to work with the NHS in introducing these crucial new nurses so that every cancer patient will get the gold standard of care.

"Too many cancer patients and cancer survivors do not get the right support to meet their varied needs.

"Specialist cancer nurses provide invaluable care and support from the point of diagnosis, throughout treatment and after." </p

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This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

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Genes reveal ‘biological ageing’

February 8, 2010 – 2:00 pm

Gene variants that might show how fast people’s bodies are actually ageing have been pinpointed by scientists.

Researchers from the University of Leicester and Kings College London say the finding could help spot people at higher risk of age-related illnesses.

People carrying the variant had differences in the "biological clock" within all their cells.

The British Heart Foundation said the findings could offer a clue to ways of preventing heart disease.

While doctors know that as people age they are more at risk from diseases such as Alzheimer’s, Parkinson’s and heart disease, some people fall prey to these at an earlier age than expected.

Telomeres

One theory suggests that biological timers called "telomeres", part of the chromosomes in every cell that carry genetic code, may be a factor in this.

"What our study suggests is that some people are genetically programmed to age at a faster rate"

Professor Tim Spector, King’s College London

From birth, every time a cell divides, the telomeres get shorter and there is some evidence that people with shorter telomeres, either because they diminish more quickly or because they were born with shorter versions, may be at higher risk from age-related illness.

The researchers say in the journal, Nature Genetics, that they looked at more than 500,000 genetic variations across the entire human genome to see which variants cropped up more frequently in people known to have shorter telomeres.

They eventually located a number of variants located near a gene called TERC which, in people carrying them, seemed to be equivalent to an extra three or four years of "biological ageing".

Bad lifestyles

Professor Tim Spector, from King’s College London, said: "What our study suggests is that some people are genetically programmed to age at a faster rate.

"Alternatively, genetically susceptible people may age even faster when exposed to proven ‘bad’ environments for telomeres such as smoking, obesity or lack of exercise - and end up several years biologically older or succumbing to more age-related diseases."

Professor Jeremy Pearson, associate medical director at the British Heart Foundation, which part-funded the study, said it was not yet clear whether telomeres did contribute to an increased risk of disease.

He said: "Understanding how our cells age is an important step in our quest for better ways to prevent and treat heart disease.

"Perhaps in the future one of the ways we try to reduce the risk of, or treat, heart disease would be to use an ‘anti-ageing’ approach for our arteries." </p

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Better child-diabetes care urged

February 8, 2010 – 8:00 am

A "shocking" number of children are being rushed to hospital each year with potentially fatal complications of diabetes, according to a charity.

Many of the 3,300 cases in England in 2008/9 could have been prevented by better care, says Diabetes UK.

It said that families still found it hard to access specialist diabetes teams and that high admission rates had been linked to service cuts.

There are an estimated 25,000 young people in the UK with type 1 diabetes.

The condition is most often diagnosed between the ages of 10 and 14.

"It’s shocking to see such high numbers of children being rushed to A&E with this life-threatening condition"

Douglas Smallwood, Diabetes UK

People with type 1 diabetes are dependent on daily insulin injections, alongside a controlled diet and frequent blood testing to check blood sugar levels.

If poorly managed, or left undiagnosed, it can cause a complication called diabetic ketoacidosis (DKA).

This can involve a variety of symptoms, including nausea, vomiting, stomach pain, rapid breathing and, if left untreated, can lead to coma or death.

There were a total of 13,465 hospital admissions for DKA in the year to April 2009, a quarter of which involved children and young people under 18 years old.

The figures show a steady rise over recent years, with an increase of almost 9% since 2006.

The charity said the rise could be blamed on both children being diagnosed later, when their condition had deteriorated further, and on a failure to manage their condition properly once a diagnosis had been made.

‘Investment needed’

Douglas Smallwood, Diabetes UK’s chief executive, said: "It’s shocking to see such high numbers of children being rushed to A&E with this life-threatening condition."

He said that previous research had suggested that rises in emergency admissions were often preceded by specialist diabetes staff reporting cuts in services.

"Children and their parents desperately need better access to paediatric specialist diabetes teams.

"The number of emergency admissions could be reduced significantly with investment in appropriate care, diabetes advice and practical self-management support."

The charity said that the UK had the fourth highest levels of type 1 diabetes in Europe, and the lowest number of children whose condition was well-controlled. </p

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Artificial pancreas diabetes hope

February 8, 2010 – 2:00 am

Scientists have shown that an "artificial pancreas" can be used to regulate blood sugar in children with Type 1 diabetes.

A UK trial found that combining a "real time" sensor measuring glucose levels with a pump that delivers insulin can boost overnight blood sugar control.

The Lancet study showed the device significantly cut the risk of blood sugar levels dropping dangerously low.

Experts said the results were an important "step forward".

Type 1 diabetes is a chronic, life threatening condition, in which the pancreas does not produce insulin - the hormone that regulates blood sugar levels.

"We need to redouble our efforts to move the artificial pancreas from a concept in the clinic to a reality in the home of children and adults with Type 1 diabetes"

Karen Addington, Juvenile Diabetes Research Fund

‘Pump has been really liberating’

In total, 17 children and teenagers with Type 1 diabetes took part in the study over 54 nights in hospital.

Individually, the glucose monitoring system and the insulin pump used in the study are both already widely used and commercially available.

But in order to turn them into a "closed loop" system which monitors the patient’s condition and delivers treatment accordingly, the researchers developed a sophisticated algorithm to calculate the appropriate amount of insulin to deliver based on the real-time glucose readings.

They then measured how well the artificial pancreas system controlled glucose levels compared with the children’s regular continuous pump, which delivers insulin at preselected rates.

Low blood sugar

Testing was done in different circumstances - for example on nights when the children went to bed after eating a large evening meal or having done early evening exercise - both of which can increase the risk of low blood sugar episodes known as hypoglycaemic attacks or "hypos".

• 1 - Continuous glucose sensor monitors blood sugar level
• 2 - Data transmitted for the computer programme to work out insulin dose
• 3 - Insulin pump delivers the dose

Overall, the results showed the artificial pancreas kept blood glucose levels in the normal range for 60% of the time, compared with 40% for the continuous pump.

And the artificial pancreas halved the time that blood glucose levels fell below 3.9mmol/l - the level considered as mild hypoglycaemia.

It also prevented blood glucose falling below 3.0mmol/l, which is defined as significant hypoglycaemia, compared with nine hypoglycaemia events in the control groups.

Study leader Dr Roman Hovorka said: "This is the first randomised study showing the potential benefit of the artificial pancreas system overnight using commercially-available sensors and pumps.

"Our study provides a stepping stone for testing the system at home."

Karen Addington, chief executive of Juvenile Diabetes Research Fund, who funded the research said the study provided "proof of principle" of an artificial pancreas.

"We need to redouble our efforts to move the artificial pancreas from a concept in the clinic to a reality in the home of children and adults with type 1 diabetes."

Dr Victoria King, research manager at leading health charity Diabetes UK, said: "This is an important step forward in managing overnight blood glucose levels as well as in the eventual development of a full ‘artificial pancreas’ which could vastly improve the quality of life for people with type 1 diabetes and reduce the risk of the associated complications." </p

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This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

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Card carriers

February 7, 2010 – 8:00 pm

By Jane Elliott
Health reporter, BBC News

For Colin Corker has experienced the dilemma of organ donation from both sides - his wife’s organs helped four people after her sudden death and five years later his daughter needed her own transplant.

When Christine Corker died aged 43 in 2001 her husband Colin had no hesitation in releasing her organs for transplant and her kidneys, liver and lungs were donated to four strangers.

Christine had a donor card and Mr Corker, 63, from Leeds, said: "I am glad I did it. It is what she wanted.

"You can’t take them with you."

Five years later he had reason to be grateful to a donor’s family after a virus destroyed his 12-year-old daughter Lauren’s kidneys.

She got an organ, but others are not so lucky, and Mr Corker is a strong advocate for carrying donor cards.

Donor shortfall

Statistics from the NHS Blood and Transplant (NHSBT) show that despite 96% of people saying that they would accept a donor organ, only 27% have actually signed up for the Organ Donor Register themselves.

"Christine had a donor card and I said they could have what they wanted, I just had to sign on the dotted line"

Colin Corker

Jeanette Foley, donor transplant co-ordinator for London, said it was important people registered for organ donation rather than just carrying a card.

"The donor cards were brilliant when they came out," she said.

"But people lose them or keep them in wallets, which aren’t always checked in accidents.

"There is a huge disproportion of people donating and wanting an organ. And the fact that people die every day gives an indication of this.

"We are nowhere near the amount of organ donors we need."

The original kidney donor card was launched in the 1970s and the NHS Organ Donor Register followed in October 1994.

Mr Corker said he took every possible opportunity to stress the importance of carrying a donor card.

"I push it all the time, even at work I ask people whether they are on the donor list."

‘Grateful recipient’

However, he stressed it had been an easy choice to make about releasing his wife’s organs as she had made her own choices so clear.

"I got a phone call from the landlady of the pub, where Christine worked, saying that my wife had collapsed," he said.

"I knew she had been working hard and was on a detox diet and I thought she had overdone it. She had lost the use of one side of her body.

"The last thing she said to me was: ‘My head feels like it is going to explode’. An ambulance came and she had six seizures in 10 minutes."

ORGAN DONATION

• Between 1 April 2008 and 31 March 2009, 3,513 organ transplants were carried out from 1,853 donors
• 977 lives were saved in the UK through a heart, lung, liver or combined heart/lungs, liver/kidney, liver/pancreas, heart/kidney or liver/kidney/pancreas transplant
• A total of 2,536 patients received a kidney, pancreas or combined kidney/pancreas transplant
• A further 2,711 people had their sight restored through a corneal transplant
• At the end of March 2009, 7,877 patients were listed as actively waiting for a transplant

Mrs Corker, who was 43, was rushed to hospital with a brain haemorrhage.

She was in a coma for two days, but was declared clinically dead in 2001.

"The man from the transplant unit came and said, ‘Have you considered donating your wife’s organs’" Mr Corker said.

"Christine had a donor card and I said they could have what they wanted, I just had to sign on the dotted line.

"They took both kidneys, lungs, liver - they couldn’t use her heart because of the drugs she had been given.

"Somebody who had suffered from cystic fibrosis all her life got her lungs. Unfortunately she later died, but I think the other three are still surviving."

He said his daughter Lauren, now 16, had also been a grateful recipient of a donation from a stranger - thanks to the family of a 22-year-old road traffic accident victim.

"Lauren had been on dialysis for two years. It was a really good match. It could not have been closer and everything has gone beautifully since.

"You just can’t say how grateful you are to the donor."</p

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This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

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Muscle madness

February 7, 2010 – 2:00 pm

Bob Howard
The Donal MacIntyre Show, BBC Radio 5 live

"My mate was taking steroids and he was getting bigger and bigger, and then another friend started them and I felt sort of left out. That’s why I started."

Jack was 18 when he first took steroids and conscious of the perceived benefits of honing a chiselled body.

"Women generally like defined, big blokes. It’s like going back to caveman times - I’m the king of the castle.

"You’re at a gym, you’re like ‘aah, I’m lifting more than him, he’s nothing’."

The latest figures from the British Crime Survey, published by the Home Office, estimate 23,000 young men between the ages of 16 and 24 have used steroids.

For many years steroids were associated with competitive body builders and the odd professional sporting scandal, but some drug charity workers say the age profile is gradually becoming younger.

"I was getting anger problems; I would suddenly lash out at my friends if they just said the wrong thing to me"

Jack, former steroid user

Roy Jones works for the drug charity Turning Point, where its Smart Muscle programme offers support to steroid users.

He says more and more young men like Jack are experimenting with steroids.

"There are needle exchanges around the country which are seeing more steroid users than any other drug user combined coming to their services so it is definitely on the up," he said.

Vulnerable

The law says it is illegal to sell steroids in the UK, but not against the law to buy them.

Many users purchase their steroids online, including Jack.

He told Radio 5live’s Donal MacIntyre programme: "I went on the site, ordered them, really easy, shocking really. All you had to do was tick a box that you were over 18.

"You could be eight years old and tick that box as long as you can read and write and understand what’s going on.

"Six days later they were delivered to my door."

Anabolic steroids mimic the effects of the natural male hormone testosterone. They increase protein synthesis within cells, which in turn helps to build muscle tissue.

But using steroids, especially when the body is still developing, can prove very harmful.

Mr Jones says boys in their late teens are especially vulnerable to damaging themselves.

"Testosterone as you go through puberty starts to slow down the growth of your long bones," he said.

"So if you’re still growing and you feel like you want to grow a bit more, taking synthetic testosterone is not a good idea."

Receding hair

But Jack liked the results he was seeing so much he quickly began to take double the recommended dosage.

It was then that he started to suffer physical and psychological side-effects.

"I was getting anger problems; I would suddenly lash out at my friends if they just said the wrong thing to me.

"Before I had really thick hair and whilst I was on them I noticed my hair went thinner and thinner. I’m receding and I’m only 20.

"Then I ended up developing breast tissue."

After an emergency trip to hospital, for an incident unrelated to his steroid use, Jack finally had to admit taking the drugs to a concerned doctor who noticed he had a damaged liver.

This shocked his mother, Sandra, who was completely unaware her son was taking steroids.

"I thought his moodswings were typical teenage adolescent behaviour.

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"Obviously I was aware he was getting bigger and bigger but he was, to be fair, working hard at the gym as well."

"It hadn’t rung alarm bells, but perhaps it should have with me."

Jack’s parents gave him an ultimatum to give up his steroid use or leave home.

Jack abided by his parents wishes and now trains without the help of steroids.

‘Horrible time’

The parents of 17-year-old Matthew Dear were also unaware that their son had started taking steroids.

Matthew had always dreamt of joining the Royal Marines and last March he started taking a course of steroids to boost his body size.

"Matthew was such a healthy living kid, he didn’t even like taking paracetamol if he had a cold," said Matthew’s father, Chris.

"To find out that he had joined the gym and bought some steroids off of another 17-year-old kid at the gym, we were gobsmacked."

It only came to his attention after Matthew had begun to increase his dose from one tablet per day, to four a day and began to feel ill.

"He wasn’t able to walk properly, he didn’t know where he was, he was very confused. We were worried so we called an ambulance," said Matthew’s mother, Tina.

It was only when he confessed to the ambulance crew that he had been taking steroids that Matthew’s parents found out that he had been taking the drugs.

"He seemed to start going downhill very quickly, that was a horrible, horrible time," said Mrs. Dear

"They did some more tests and then they said the brain had crushed the stem and he wasn’t going to come round from that."

On the April 20, 2009 Matthew died - four weeks after he started taking steroids.

Matthew’s case is exceptionally rare and, while the initial post-mortem report cited anabolic steroids as one of the causes of his death, medical opinion is split.

Matthew’s parents are awaiting a coroner’s inquest to determine exactly how he died.

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Listen to the full report on the Donal MacIntyre programme on BBC 5 live on Sunday, 7 February 2010 at 1930 GMT or download the free podcast

Contact the programme by email: donal@bbc.co.uk</p

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This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

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Pledge of one-to-one cancer care

February 7, 2010 – 8:00 am

Gordon Brown has promised reforms in the social care system to try to prevent the financial worry of old age.

In his regular Downing Street podcast, the prime minister said people in middle Britain would benefit from "guarantees" over end-of-life care.

Free personal care for the elderly in England is likely to be one of the key planks of Labour’s election strategy.

Further announcements on social care and cancer treatment policies are expected this week.

‘Firm assurances’

Mr Brown said: "It’s not fair that so many people already struggling with the loss of independence - who have worked hard all their lives and saved for their retirement - are faced with the prospect of running down their savings or selling their homes to fund their care.

"Or that those seeing their parents and grandparents suffering from conditions like Alzheimer’s and dementia not only have to watch as their dignity fades, but have the heartbreak made worse by the costs of getting support.

"So I am proud that we are about to bring forward a new system of social care that will directly benefit many families of middle Britain."

"We’ll also ensure everyone has dignity and security in their old age"

Gordon Brown

Mr Brown said there needed to be "firm assurances" for providing care to those who need it.

"In health, our support means offering guarantees, not gambles - including treatment within 18 weeks and being seen by a cancer specialist within two.

"We’ll also ensure everyone has dignity and security in their old age."

The free personal care proposal was originally put forward by Mr Brown at Labour’s conference, and is currently being debated in a bill before Parliament.

The bill, which would affect England, will not be implemented before the election. Scotland already has free personal care.

‘Widespread criticism’

It has attracted criticism from peers, local government and campaigners because a wider review of social care is also taking place.

It affects only about half of the 500,000 people receiving care in their own home - most of these are elderly, although some are people with disabilities.

On top of that, more than 400,000 living in care homes would not benefit from the bill.

Last summer, a Green Paper was published putting forward a series of proposals affecting the whole range of social services.

These include radical plans to impose charges, perhaps as much as a £20,000 bill payable on retirement.</p

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Beating dementia

February 7, 2010 – 2:00 am

You cannot alter your age or the genes you are born with, but there are lifestyle changes you can adopt which may reduce your chance of developing dementia by as much as 20%.

The BBC convened a panel of independent experts, chaired by the Alzheimer’s Society, which evaluated more than 70 research papers and articles to come up with a series of tips for reducing your risk.

It may sound young, but the age of 35, they suggest, is high time to start thinking about these recommendations. If more of us acted on these, thousands of cases of dementia could be prevented in the future.

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There is very strong evidence for the following:

EXERCISE

What is good for the heart is good for the brain. Exercise can have a beneficial effect at any age to help protect against dementia. To help reduce the risk at least 30 minutes of exercise, five times a week is suggested. It does not have to be the gym - a brisk walk is a perfectly acceptable alternative. Whatever form of exercise gets your heart pumping and leaves you somewhat out of breath is doing the trick. Exercise helps maintain a healthy weight and blood pressure, and so is indirectly thought to reduce the risk of dementia.

There is also growing evidence that regular exercise has other health effects such as promoting cell and tissue repair mechanisms including growth of new cells in the brain.

NOT BEING OBESE

Being seriously overweight is deemed a risk factor for developing dementia. This really matters in mid-life - between the ages of 35 and 65. Obesity increases the likelihood of developing Type 2 diabetes - believed to be a risk factor - but whether this causes the disease, or is simply more likely to develop in those who also more prone to dementia is unclear. Obesity is also associated with higher cholesterol and blood pressure - again, known to be risk factors. You are deemed clinically obese - very overweight - if you have a BMI of 30 and above.

Check your BMI here with our calculator

BRING DOWN HIGH BLOOD PRESSURE

Again, the key here is having consistently raised blood pressure in mid-life - anything above 140/90mmHg. It is thought that this increases the chance of dementia by causing damage to the brain. This may happen as a result of a stroke - in which blood supply to part or all of the brain is cut off - or due to microvascular disease, a condition which slows the flow of blood through the body thereby damaging cells and nerves in the brain. If you are over 40, or have a history of dementia or cardiovascular disease in your family, then get your blood pressure checked regularly.

REDUCE CHOLESTEROL

It is mid-life levels once more which appear to pose the greatest problem. Like high blood pressure, high levels of cholesterol raise the risk of stroke and microvascular disease. But cholesterol is also thought to be involved in the mechanism which causes amyloid protein plaques - the protein deposits that characterise Alzheimer’s disease - to build up. Again if you are over 40 or have a family history, get your cholesterol checked. The Department of Health recommends a total cholesterol level of less than 5.0mmol/l.

NOT SMOKING

This had been an area of confusion, as some studies had suggested nicotine could have a protective effect - with the chemical reducing plaques when administered to animals in water. But the way in which we smoke tobacco, and the other chemicals inhaled in the process, negates this benefit. As well as raising the risk of vascular disease - a risk factor for dementia - smoking can result in low oxygen levels in the brain which in turn can promote the production of the protein found in brain plaques.

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It is possible the following may have an impact:

ALCOHOL

In fact the studies are quite clear that drinking a modest amount appears to protect against cognitive decline. Moderate drinking is defined as keeping within the recommended daily limits - up to two small glasses of wine for a woman, and three for a man. The problem is that these studies compare drinkers with non-drinkers - and people who abstain may do so for health reasons, which in turn may effect their chances of developing dementia. The message is if you are drinking within your weekly guidelines there is no need to stop, but there is no need to take up drinking or increase the amount you consume, as heavy drinking may in fact increase your risk.

FOLLOWING A MEDITERRANEAN DIET

Several recent studies have highlighted the potential for this diet to reduce the risk of Alzheimer’s Disease. It involves eating lots of fruit and vegetables, whole grain foods, fish and plenty of olive oil, but it is relatively low is dairy products and processed foods. Further long term research is needed to confirm the effects of eating this way.

BEING SOCIALLY ACTIVE

Some evidence suggests that an active social life throughout life can be protective, with both the social ties one enjoys with others and non-physical leisure time deemed important. However, examining these factors and designing studies which can separate their effects is very difficult - consequently the conclusions which can be drawn from results are limited. One particular study has found that being single and living alone is a risk factor for dementia: social isolation is thought to have negative effects on health generally, increasing depression and cardiovascular disease.

Studies have also suggested that engaging in non-physical leisure activities such as gardening, and knitting may have a protective effect, a benefit that is likely to accumulate gradually over decades.

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But the jury is out on:

BRAIN TRAINING

It sounds both attractive and plausible that giving your brain a "workout" could guard against dementia, and there is some evidence that very intensive brain training under strict conditions can improve specific functions like reasoning and problem solving. But there is no evidence as yet that doing a crossword a day or a number puzzle - or even learning a new language at 50 - will protect against dementia. That does mean they do not - simply that the proof that they do is presently lacking.

VITAMIN SUPPLEMENTS

There is no consistent evidence either way as to whether B vitamin supplements - folic acid, vitamin B12 or B6 - are effective in reducing the incidence of dementia. Research continues. However vitamin E supplements, which it was once hoped could prevent and even reverse early neurodegenerative changes, have not appeared to be effective in trials.

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The panel comprised of Professor Clive Ballard (Chair), Director of Research, Alzheimer’s Society, Dr Sarah Aldred, University of Birmingham, Dr Jacqueline Birks, Cochrnae Review, Oxford, Professor Carol Brayne, Institute of Public Health, University of Cambridge, Professor Mia Kivipelto, Karolinska Institute, Sweden, Dr Marcus Richards, Medical Research Council, Professor John Starr, Royal Victoria Hospital, NHS Lothian, Professor David Smith, Founding Director OPTIMA, University of Oxford, Professor Raj Kalaria, University of Newcastle</p

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Transplant first in kidney sister

February 6, 2010 – 7:56 pm

A pioneering procedure has allowed a British woman to get a new kidney from her sister - even though the organ would normally be rejected.

Maxine Bath had been kept alive by dialysis, and had no matching donors in her family.

However, doctors in Coventry used a technique called "cryofiltration" to remove the immune molecules that cause rejection.

Doctors said it could allow more people to undergo transplants.

"I’m already feeling healthier - I am looking forward to being able to eat food I couldn’t have at all before, like nuts and chocolate"

Maxine Bath

A total of 927 kidney transplants from "living donors" took place in Britain last year, although thousands more people remain on waiting lists, because a matching donor cannot be found.

Organ rejection happens when the body recognises the new organ as foreign, and the immune system reacts against it.

The risk can be reduced if the donor organ comes from another family member, and patients will often take drugs for the rest of their lives to ‘damp down’ their immune response.

However, Maxine, 41, from Wolverhampton, who had been in kidney failure for 15 years, was found to have immune system antibodies against the tissue types of all her family members, which seemed to rule them out as "living donors".

Other ways of removing these antibodies could not be used, as she had low blood pressure, and they could lower it further.

However, the new technique of cryofiltration did not present the same risk, and this is believed to be the first time it has been used to help a patient receive a non-matched organ.

The procedure involves circulating the blood plasma through a machine which heavily chills it, turning proteins and antibodies into a gel-like substance which can then be easily filtered out, before the plasma is re-warmed and returned to the patient.

Race against time

Dr Rob Higgins, a kidney specialist at University Hospitals Coventry and Warwickshire NHS Trust said: "Maxine would have gone blind within two years because of her low blood pressure, if she had not received a new kidney.

"This is another innovative measure we have implemented at the trust which opens the doors of donation for more kidney patients awaiting transplants."

Both Maxine, and her sister Michelle, who was the closest match available in the family, underwent the procedure five times before the transplant took place.

The operation, carried out in November, has already transformed Maxine’s life.

She said: "I’m already feeling healthier - I am looking forward to being able to eat food I couldn’t have at all before, like nuts and chocolate.

"Rob told me I was the first kidney patient in the world to try this technique which I thought was really exciting - it hasn’t sunk in yet." </p

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Patients’ stories

February 6, 2010 – 1:55 pm

By Jane Elliott
BBC News, Health reporter

Some black and ethnic minority groups are three times more likely to be admitted to mental health services.

But despite this health workers are worried that many people from some ethnic communities are not accessing the help they need.

Language barriers are blamed, as is a belief in certain cultures that mental health issues should not be talked about outside the family.

Raju Mehta was one who suffered from such stigma.

Drinking

When the former pilot was mugged, his whole world collapsed before him and he struggled to cope.

At first he relied on his family to help him through, a traditional response in the Indian community.

"They need help but are very proud"

Raju Mehta

But as his health deteriorated, he started drinking heavily, felt suicidal and his family could do nothing to help.

Raju knew he needed outside help, but said others were not so fortunate.

"I am a happy-go-lucky person, but when someone struck me about six years ago they destroyed my life.

"I was mugged and became depressed and, anxious to make myself feel better, I drank. I was trying to destroy my life.

"But one day I just realised that life was for living. With the help of a lot of people I learnt about counselling and help."

He said within his own community seeking help as he had was frowned upon.

"When they have a problem in the family in my community they will not say because they are worried that they will not get a boy or girl to marry their son or daughter.

"They need help but are very proud."

‘Lost cause’

Raju now volunteers to help his community, telling them about what happened to him.

This is also why he has agreed to feature in a DVD, launched by his local health authority, Hertfordshire Partnership NHS Foundation Trust.

Time To Talk, a 30-minute DVD available in 12 different languages, aims to encourage everyone to talk about their mental health and to give them advice on where to go for help.

"When I was depressed I was out of the community and family," said Raju.

"The family helped me for a couple of months then they thought I was a lost cause and instead of the family members I got help from outside.

"My family did not understand the problems and that is why I did the DVD.

"Depression is a hard subject for the Indian community."

Moira Port, a modern matron at the Lister Hospital mental health unit in Stevenage, said in some communities mental health issues remain a stigma.

And she said that just more than half of those needing help currently sought it.

"The DVD was produced by a number of service users and staff and was about improving understanding of what mental health issues are in the BME (Black and Minority Ethnic communities) community," she said.

"And how they felt that their own community view mental health issues, such as being weak or fear of stigma.

"They said that they were frightened to come out."

But she said seeking help had been shown to work.

"But the ones who managed to access mental health services have found it quite useful.

"They then feel empowered to go and talk to the community and say if you have problems, or if you feel low or weepy and upset.

"The DVD tells you how to access the services and how you would be helped."</p

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