25 minute read
HEALTHZONE
MEDICAL NOTES Are YOU suffering with this stomach disorder?
TENS of thousands of people across the region could be suffering from a serious stomach disorder – and don’t know about it.
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Coeliac disease causes the body’s immune system to react to gluten found in food, making the body attack itself resulting in a lifetime of pain and discomfort.
Diagnosing the condition has been extremely difficult with the average time being about 13 years!
But a new and simple blood test is now available so that some adults over 55 can be diagnosed almost immediately, without first having to have an endoscopy and biopsy.
The move follows new interim guidance from the British Society of Gastroenterology, pending the publication of its new Coeliac Guidelines in 2021.
Hilary Croft, chief executive of Coeliac UK, said: “This will enable a greater number of people to gain a faster diagnosis, without the need to wait for an endoscopy at the hospital.
“Getting an accurate diagnosis of coeliac disease means keeping gluten in the diet throughout the testing process – a difficult feat when waiting lists are long and people feel unwell.
“These guidelines are good news for those who meet the criteria for a no-biopsy diagnosis, who will be able to start to feel better sooner on a gluten-free diet, the only treatment for coeliac disease.
“However, those that do not meet the criteria are likely to face long waiting times as endoscopy services begin a phased return.Access to blood tests may still be limited at the moment, so we encourage people to speak with their GP if they are experiencing symptoms. ”
To make it easier to understand if symptoms are possibly due to coeliac disease and discuss further testing with your GP, Coeliac UK has developed a self-assessment test to make it easier to take that first step to diagnosis.
n Go to www.isitcoeliacdisease.org.uk
to take the online assessment.
n Coeliac UK
Helpline: 0333 332 2033
TIMEBOMBTIMEBOMB inina abottlebottle
HEALTH experts are warning that the rate of drinkrelated hospital admissions is now “a ticking timebomb ready to explode” .
Anew NHS report reveals that in 2018 1.3 million people were admitted to hospital due to alcohol – 7.4% of all hospital admissions across the country.
The numbers have risen by 60% in the last decade.
Almost half of those admitted (47%) were aged between 55 and 74 and just under two thirds were male.
NunoAlbuquerque, at alcohol addiction treatment experts UKAT, said: “This country’s problem with alcohol is a ticking timebomb about to explode. The NHS is crippling under pressures directly attributable to the misuse of alcohol.
“What will it take to make the Government sit up, listen and take effective action? Why do we still not have an alcohol-specific strategy, as promised back in 2018? It is a huge problem and one that needs immediately addressing as a matter of urgency. ”
The biggest reason for admission into hospital was for cardiovascular disease, accounting for 645,070 (51%) of all admissions.
Afurther 17% (220,730) of all admissions were for mental and behavioural disorders due to alcohol, conditions which include acute intoxication, harmful use of alcohol, dependence to alcohol and withdrawal from alcohol. Other conditions for hospital admission due to alcohol include breast cancer, alcohol poisoning, and alcoholic liver disease. Almost 5,700 people died due to drink – 2% lower than in 2017 but a 7% rise in 10 years. The NHS report also shows 170,000 prescribed drugs were issued in 2018, 27% more than in 2008. MrAlbuquerque added: “The NHS is being forced into a corner when it comes to tackling alcohol misuse. GP’s prescribing drugs likeAcamprosate Calcium, Disulfiram and Nalmefene will only pause the problem, not solve it. “Taking this sticky-plaster approach is also a false economy, costing the NHS an eye-watering £4.32m last year alone. ” n For help and support with alcohol, visit
www.ukat.co.uk/alcohol/v7/
Make time to love your liver
HALF OF all liver disease patients had no signs or symptoms before their diagnosis, a new study reveals.
The largest ever survey of UK liver patients – also showed that a quarter were diagnosed at a very late stage when there were very few options for treatment and intervention.
One in five had been dismissed or sent home with medication without further investigation when they first visited their GP.
The survey also reveals: n Athird of patients were diagnosed after being tested for another condition. n Tiredness, abdominal pain and itching were the most common symptoms experienced by half of the respondents. n More than half felt they were given not enough or no information upon diagnosis. n 22% waited more than six months before being
Three top tips referred to a specialist. THE British Liver Trust’s three simple steps to Love Your Liver back to health: n Drink within recommended limits and have three consecutive days off alcohol every week. n Maintain a healthy weight by eating well and taking more exercise. n Know the risk factors for viral hepatitis and get tested or vaccinated if at risk. To find out if you are at risk visit www.britishlivertrust.org.uk/screener n Evidence shows the earlier a patient is diagnosed, the greater their chance of survival: 90% of liver disease is preventable. Professor Stephen Ryder, consultant at Nottingham University NHS Trust, said: “We have equipped GPs with a very poor test for diagnosing liver disease –Liver Function Tests (liver enzymes). Repeat testing of liver enzymes just wastes NHS money and does not provide early diagnosis. “We now have excellent tests for liver scarring, the process which matters in the liver, and those tests should now be universal in primary care. ” Pamela Healy, chief executive, British Liver Trust, said: “The UK is facing a liver disease crisis. Liver problems often develop silently as patients do not tend to experience symptoms until the disease has progressed. ”
‘Kinder’ ways to treat kids’ cancers
RESEARCHERS have made an important breakthrough that could lead to kinder treatments for children with bone cancer, and save lives.
Current treatment is gruelling, with outdated chemotherapy cocktails and limb amputation. The five-year survival rate is poor at just 42% – largely because of how rapidly bone cancer spreads to the lungs.
New research identifies a set of key genes that drive bone cancer spread to the lungs in patients.
In further experiments in mice with engineered human bone cancer cells that lack these key genes, the cancer cannot spread to the lungs.
The research was led by Dr Darrell Green, from the University of East Anglia’s Norwich Medical School and Dr Katie Finegan from the University of Manchester.
Dr Green said: “Primary bone cancer is the third most common solid childhood cancer, after brain and kidney, with around 52,000 new cases every year worldwide.
“These findings are really important because not only do we now have a gene pathway associated with metastasis, we know that removing this gene pathway actually stops cancer spread in a live animal.
“And we also know how and why this is happening through hijacking the immune system.
“The next step already gearing up to take place is to silence this pathway in treatment form.
“If these findings are effective in clinical trials, it would no doubt save lives and improve quality of life because the treatment should be much kinder compared to the gruelling chemotherapy and life-changing limb amputation that patients receive today. ”
Plant and meat diet
YOU don’t have to give up meat and dairy altogether if you want to lower your blood pressure, according to new research.
Moving toward a more plantbased diet will be effective, even if small amounts of meat and dairy are included, a study found.
Ateam of researchers argue that any effort to increase plantbased foods in your diet and limit animal products is likely to benefit your blood pressure and reduce your risk of heart attacks, strokes and cardiovascular disease.
They conducted a systematic review of previous research from controlled clinical trials to compare seven plant-based diets, several of which included animal products in small amounts, to a control diet and the impact that these had on blood pressure..
Joshua Gibbs, who led the work at Warwick Medical School, said: “This is a significant finding as it highlights that complete eradication of animal products is not necessary to produce reductions and improvements in blood pressure.
“Essentially, any shift towards a plant-based diet is a good one. ”
MS BREAKTHROUGH
SCIENTISTS have made what they describe as a Holy Grail discovery to protect nerves from damage and prevent disability in multiple sclerosis.
Remarkably, they’ve also discovered that a readily available diabetes drug (pioglitazone) could be a potential treatment.
In MS the protective coating that surrounds nerves, known as myelin, is damaged and nerves become less energy efficient as a result. Not having the energy they need makes nerves vulnerable to damage and causes disability over time.
But for the first time researchers at the University of Edinburgh – funded in part by the MS Society – have discovered a natural mechanism in the body that tackles this issue, which they are callingARMD (axonal response of mitochondria to demyelination).
Although this natural function alone doesn’t provide enough energy to address demyelination in MS, the discovery raises the possibility of using a drug to enhance it. Research now suggests pioglitazone – currently used to treat diabetes – could be the answer.
Dr Don Mahad, leading the study at the University of Edinburgh, said: “Although our understanding of MS has vastly improved over the last two decades, new therapies still do not protect nerve fibres.
“Such protection is the Holy Grail in MS treatment – not only for the relapsing form of MS, which has various options available, but for progressive forms too, where treatment continues to lag behind.
Diabetes drug
“Our discovery shows that nerves respond to myelin damage by increasing the movement of mitochondria (the cell powerhouse, which produces energy) to the area of damage – a response we’re callingARMD.
“Remarkably, we were able to enhance ARMD and protect these vulnerable nerves using the readily available diabetes drug pioglitazone. This is an incredibly important discovery – one we believe could finally bridge the gap in MS treatment. ”
Over the last few decades there have been huge strides made in our understanding of MS, and there are now over a dozen effective treatments for people with relapsing MS – but these only address damage that is caused by the immune system.
“In order to truly stop MS and find treatments for everyone, ways need to be found to both protect nerves from further injury and repair damaged myelin.
Last year, another MS Society funded study found that a different diabetes drug – the fasting mimetic drug metformin –was able to return cells to a more youthful state, and encourage the re-growth of myelin.
Dr Emma Gray, MS SocietyAssistant Director of Research, said: “Currently, there are no effective neuroprotective therapies available for MS, but Dr Mahad’s research demonstrates we are getting closer – and finding treatments for everyone with MS is now a very real prospect. ” n MS Helpline: 0808 800 8000
MEDICAL NOTES Rare muscle link, but keep taking the statins
A SMALL minority of people taking statins to reduce their risks of heart attack and strokes could be more susceptible to myopathy, a rare and painful muscle condition.
But the overall benefits of taking them far outweigh the risks of developing the condition.
Astudy by a team at the University of Oxford found that myopathy was rare, occurring on average in only one per 1,000 people during each year of statin treatment.
There was a higher risk of myopathy in people on a higher statin dose, and in those who were older, female, of Chinese vs European ethnicity, had diabetes or lower body mass index, as well as those using other medications.
Dr Jemma Hopewell, who led the study, said: “We saw a very clear distinction between risk of statin-related myopathy and reports of other muscle symptoms.
“This new evidence, along with that from randomised-controlled trials, suggests that the vast majority of aches and pains that statin-users suffer are not caused by the drug. ”
EXERCISE has beneficial effects on the immune system during prostate cancer, a new study has found.
Researchers found that a moderate bout of exercise kept the cell count of some immune cells at a normal level.
Exercise helps the immune system mobilise by causing natural killer (NK) cells to move into the blood and be transported to areas of need, such as sites of infection or tumours.
At the tissues, these cells move out of circulation and in cancer patients they can infiltrate the tumour and potentially slow the tumour’s rate of growth, the study at the Victoria University,Australia found
Prostate cancer exercise
Tablets and the elderly
RESEARCHERS have been handed £156,000 to help frail elderly people manage multiple medicines safely.
Dr Beth Fylan, at the University of Bradford, says: “Frail older people’s medicines regimens are often extremely complicated and it requires significant work to manage them safely.
“When older people aren’t supported to do this, they may be more likely to be admitted into hospital or suffer a fall from which they can find it hard to recover, leading to a downward spiral.
“Our aim is to help them manage things better, so they never enter that cycle. ”
The project is being funded by the National Institute for Health Research.
MEDICAL NOTES Can YOU take part in Parkinson’s research?
Picture taken pre-lockdown
Volunteers stopping
PEOPLE affected by Parkinson’s disease are being encouraged to take part in a nationwide, two-year project aimed at getting a better understanding of the role of Parkinson’s Nurses.
The charity Parkinson’s UK says a specialised nurse can save an NHS Clinical Commissioning Group up to £43,812 in avoided consultant appointments, £80,000 in unplanned admissions to hospital and £147,021 in days spent in hospital on average each year.
Researchers at Northumbria University want to hear from people with Parkinson’s, and their families and carers, about their experiences of their Parkinson’s Nurse. They are also looking to hear from specialist nurses working in what is, or was, traditionally a Parkinson’s Nurse Specialist role.
Katherine French, at Parkinson’s UK, said: “This exciting study will allow us to examine on a large scale the real impact these nurses are making to the lives of people with Parkinson’s. ”
Parkinson’s is the fastest growing neurological condition in the world and currently there is no cure. In the UK, 145,000 people are currently living with the condition.
n www.northumbria.ac.uk/ParkinsonsNU
scores of strokes
AROUND 80 fewer people a year living on the North West coast will suffer strokes thanks to a
SAVING LIVES: Dr Liz Mear, chief executive of the InnovationAgency, withAFAmbassadors
NEW THINKING ON DOWN’S . . .
Head and back pain link
PEOPLE with persistent back pain or persistent headaches are twice as likely to suffer from both disorders, a new study has revealed.
The results suggest an association between the two types of pain that could point to a shared treatment for both.
Professor Martin Underwood, from Warwick Medical School, said: “In most of the studies we found that the odds were about double – either way, you’re about twice as likely to have headaches or chronic low back pain in the presence of the other, which is very interesting because typically these have been treated as separate disorders and then managed by different people.
“But this makes you think that there might be, at least for some people, some commonality in what is causing the problem. ”
Prof Underwood added: “Ajoint approach would be appropriate because there are specific treatments for headaches and people with migraine.
“There is a need for doctors and other healthcare professionals to think that when treating one issue to ask about the other and tailor the treatment accordingly. ” AN EXCITING new study has overturned the belief that brain function in people with Down’s syndrome cannot be improved.
Ateam of scientists say cognitive skills like planning and organising, short-term memory, attention and concentration can all be boosted with a special course of brain training.
Historically, it’s been thought that people with Down’s syndrome could not improve in cognitive function because of the genetic nature of the condition.
This new study suggests the contrary, underscoring that the cognitive abilities of people with genetic conditions need not be viewed as unalterable.
Dr. Henry Mahncke, head of Posit Science, whose BrainHQ software helped with the research, said: “Because Down’s syndrome is a genetic disorder, people have thought that the brain function and cognitive abilities could not be changed.
“These exciting results suggest that’s not true. We hope these initial results spur further research, including randomised controlled trials, with this important group of people. ”
Researchers atAristotle University of Thessaloniki, Greece, found a 10-week combined protocol of physical exercises and computerised brain training led to a reorganization of the brain and to improved performance on both cognitive and physical
People’s measur used in version es. The cognitive training the study was the Greek of the commerciallycognitive available BrainH Posit Science. The team took Q brain physica a l, pp from skills CAN cognitive, and resting-state EEG assessments of 12 adults with Down’s syndrome before and be improved after a 10combined training. week physi co cal urse and of cognitive The physical training consisted of aerobic, flexibility, strength, and balance exercises. The cognitive training was via BrainHQ, consisting of 29 visual and auditory exercises targeting memory, attention, processing speed, problem-solving, navigation, and social skills. The researchers had hypothesised that the training would trigger the brain’s neuroplasticity –its ability to change chemically, structurally, and functionally. Their results showed increased connectivity within the left hemisphere and from left to right hemisphere, as well as improved performance on physical and cognitive assessments. Physical improvements were reported in upper body strength and endurance (arm curl), and in mobility, and static and dynamic balance. There were also gains in general cognitive capacity. The researchers’ report said: ‘Our results reveal a strong adaptive neuroplastic reorganisation, as a result of the training that leads to a more complex and less-random network, with a more pronounced hierarchical organisation. “Our findings underline the ability of the Down’s syndrome brain to respond to the cognitive demands of external stimuli. ”
programme to detect and treat irregular heart rhythms.
Ambitious national targets were set five years ago to find and treat people with atrial fibrillation orAF – the most common form of heart rhythm disturbance, and one which can cause devastating disabilities.
More than 24,000 people were believed to be living with AF on the North West coast without realising it and efforts to find those “missing” cases have been proving highly successful.
The InnovationAgency, set up to help the NHS spread new ideas in health and social care in the region, achieved a 98% detection rate against a Public Health England target of 85% in 2018/19 – making it the highest performing area and exceeding the national target for 2029.
Apartnership approach helped the agency to engage the whole healthcare system in helping to detect people withAF and improve care in Cheshire, Merseyside, South Cumbria and Lancashire.
That included training more than 70 volunteerAF Ambassadors to test pulses in their communities, and training fire and rescue services to perform pulse checks during community “safe and well visits” .
Dr Julia Reynolds, Head of Programmes at the Innovation Agency, said: “We are delighted that all the hard work in our region in testing pulses, has resulted in more people being identified with AF and treated to prevent potential strokes. We have already started to see a reduction inAF-related strokes. n AF is responsible for
about 20% of all strokes and if left untreated, can lead to serious complications, such as heart failure or stroke.
GrowGrow bloodblood your ownyour own vesselsvessels
MEDICAL NOTES New tool could prevent many strokes and deaths
WORK is under way to develop the first ever tool for predicting the risk of a cardiovascular event or death in patients who have already had a heart attack.
In the UK, cardiovascular disease (CVD) causes one in four deaths.
People with CVD are up to five times more likely to have a stroke, are six times more likely to die compared to those without, and up to half suffer a second heart attack.
Prof Mamas Mamas,
pictured, who is leading
the research at the University of Manchester, said: “This is an incredibly exciting project that we hope will be able to make a real difference to survivors of heart attacks.
Revolutionary method could be a lifesaver
THE lives of millions of people with heart failure and circulation conditions could be dramatically improved – by growing new vessels in the heart.
Researchers are investigating revolutionary ways of treating people who have suffered heart attacks.
Aheart attack is caused by a blockage of one or more coronary arteries of the heart, which prevents blood and oxygen reaching the heart muscle.
Current treatment includes reopening the blocked coronary artery with stents or bypass surgery, though the damage caused by a heart attack can lead to heart failure.
The potential new treatment increases the blood flow to damaged heart tissue by using drugs that encourage the body to grow new blood vessels.
Heart Research UK is funding the project, being led by Prof Paolo Madeddu, at the University of Bristol.
His team discovered that an excess of a protein called BACH1 can prevent blood vessel formation.
Prof Madeddu and his team hope to show that the use of BACH1 inhibitors can stimulate the growth of new blood vessels
If successful, this would be the first step in developing them into drug treatments for heart disease.
It could also benefit people suffering from other diseases where new vessel growth is needed, such as poor blood circulation in the legs, or damage to other organs, such as the kidney, brain and eyes. Prof Madeddu said: “If we are successful, the door will be opened for a whole new method
HOPE: Professor Madeddu
of treating people who have suffered damage to their hearts. The ability to stimulate the growth of new blood vessels will allow us to drastically improve the quality of life of patients who may be at risk of heart
‘We’re paying – you get grafting!’
SCIENTISTS aiming to make grafted blood vessels more resilient have been awarded a grant of over £145,000 by national charity Heart Research UK.
Coronary heart disease (CHD) occurs when one or more of the blood vessels that supplies the heart muscle with oxygen-rich blood becomes blocked. Untreated, this can lead to angina, heart attack and heart failure. CHD is the single biggest killer in the UK. One of the current treatments is coronary artery bypass graft (CABG) surgery where a grafted blood vessel is used to bypass the blockage, restoring blood flow to the heart. Although CABG is very effective, over time the grafted blood vessel itself often becomes blocked.
There is evidence, however, that it is possible to alter the characteristics of blood vessels to make them more resilient, so that they are less prone to becoming blocked and failing.
The project, led by Dr Denise McDonald, senior lecturer from the Wellcome-Wolfson Institute for Experimental Medicine at Queens University Belfast, will use a range of laboratory models to test two key compounds that are important in in promoting resilience in grafted vessels.
Dr McDonald and her team will investigate the interaction between these chemicals in order to develop novel ways of protecting blood vessels from graft failure, with the aim of preventing vein graft failure and improving the success of CABG surgery for treating patients with CHD.
She said: “This is an incredibly interesting area of study, one that could potentially have real and applicable benefits to patients.
“By increasing the resilience of grafted vessels, we will decrease the need for extra surgeries and procedures, easing the strain on our health service and reducing the amount of medical intervention a patient needs. ”
Puzzle of high salt diet
THE KEY to treating high blood pressure might lie in people who are “resistant” to developing the condition even when they eat high salt diets,
shows new research.
With one in four adults suffering from high blood pressure in the UK, and over 1.1 billion people across the globe, it is one of the biggest unsolved global public health issues to date.
High blood pressure is also a leading cause of other serious diseases.
While some people’s blood pressure spikes when they eat high-salt diets, others, called salt-resistant, are able to get rid of salt more effectively and thus don’t experience changes in blood pressure.
One way to combat blood pressure would be to mimic what these people are doing to avoid high blood pressure.
Boston University School of Medicine looked at how cells in the hypothalamus region of the brain controlled saltresistance and found a structural change in the cells that allows for them to change their response to salt.
First author Jesse Moreira said: “Our findings have implications for the development of personalised antihypertensive therapeutics designed to bring about saltresistance in the body. ”
The research was published in
Experimental Physiology.
AUTUMN CHECKLIST
FLOWERS: Start to plant spring bulbs such as crocus, daffodils and hyacinths but leave tulips until November to reduce the risk of frost damage to premature young shoots and of the disease tulip fire. Split the roots of older herbaceous perennials such as phlox, delphinium and peony. Dig up overgrown clumps, cut off sections from the edge, each with a few shoots and some roots attached, and plant these.
SHRUBSAND TREES: Plant new roses, hedging, shrubs and trees. Evergreens in particular are best planted in early autumn. Water camellias, rhododendrons and azaleas thoroughly if the ground is dry. Clip hedges and topiary, removing all new growth unless it is needed to fill gaps or add height.
LAWNS: Raise the mower blades to give the grass a chance to thicken up in autumn. Spike the lawn to improve drainage, reducing moss and weeds, and encouraging grass growth. Apply an autumn feed high in phosphate, formulated for root growth.
PONDS: Remove blanketweed and excess duckweed; pull off the dying leaves of water plants.
VEGETABLES: Save seeds of runner and French beans to sow next year. Leave old pods to dry on the plants then pick them before they split. Store the seeds in a dry, frost-free, mouseproof place.
FRUIT: Check remaining apples for ripeness by cupping them in your palm and twisting your hand gently. If ripe, they will snap off. Store apples in single layers, not touching each other.
HERBS: Propagate rosemary from semi-ripe cuttings (woody cuttings which can still be bent without breaking); split wellestablished clumps of chives and mint.
GLASS: Stop feeding but continue to water tomato and other crop plants regularly and evenly. Remove lower leaves as they turn yellow. In mid-autumn pick all remaining tomatoes and take them indoors to ripen or make chutney.
HOUSEPLANTS: Give a weekly liquid feed to plants due to flower in autumn or winter.
OUROUR FANTASTICFANTASTIC
SHEER PERFECTION: Regal Lily GLORIOUS DAYS: Rose Peach
These cheerful put a smile on
TO CELEBRATE
All Together NOW!’s
15 fantastic years, here’s a bouquet of 15 fabulous flowers.
We start in late summer when the rocket-like YUCCA launches its huge spikes of white, tapering bells from a base of striking – and spiky – leaves.
Two spectacular species are Yucca filamentosa and Yucca gloriosa, with floral spikes 2 metres or taller.
This is also the best time to appreciate HELENIUM, which has daisy flowers with turned-down petals in shades of bronze, orange, red and yellow.
They are perennials with strong, tall stems making them ideal for cutting. The varieties Moerheim Beauty and September Fuchs have rich autumnal colours.
As autumn arrives DAHLIA tops the bill with vivid colours and dramatic shapes.
Flower sizes range from Pompons with spherical blooms only 5cm (2in) across through Cactus types with pointed petals to Decoratives which produce blooms up to 30cm (1ft) across.
Then the CHRYSANTHEMUM takes over, also in many bright colours and an array of shapes and sizes. In late autumn, when few plants blossom, the 10cm (4in) flower stems of the hardy CYCLAMEN species Cyclamen hederifolium materialise from the ground where apparently nothing was growing.
The elegant blooms with swept-back petals are pink with maroon markings and have a sweet scent. The attractive, marbled leaves emerge later.Afew corms will soon spread in if planted in welldrained soil in semi-shade.
JASMINE is renowned for fragrant summer flowers but the prolific yellow-star blooms of Jasminum nudiflorum are even more welcome.As its name suggests, this climbing shrub is “nude” – with no foliage – when the long-lasting flowers open. The leaves come later.
In winter, as the old country saying reminds us, “As the days grow longer, the cold grows stronger, ” so it is delightful to see flowers which defy the weather.
IRIS is best known for spectacular late spring displays but Iris reticulata and Iris unguicularis raise perfumed blooms, usually purple or lavender with yellow markings, no more than 15cm (6in) tall.
At the same time swathes of SNOWDROP appear, looking pale and delicate but tough enough to bloom through a covering of snow.
CROCUS is a vibrant harbinger of spring, producing goblet-shaped flowers mostly in shades of white, gold or purple with prominent orange stamens.
The unusual variety Gipsy Girl is yellow with purple feathering, while no flower
