Who is Dr Lucy Reynolds?

You can see from her qualifications that Dr Lucy Reynolds is not a medical doctor, however she takes a keen interest in the way the NHS in England is changing following the Health and Social Care Act legislation last year. She is a Research Fellow at the London School of Hygiene and Tropical Medicine and her interests include the way healthcare system structure, financing and health outcomes interact.

Privatisation of the NHS will not happen with a “Big Bang.” Maybe it would have been more honest if it had been introduced in that way because it would have been obvious. If you stay in England, and you and your family use, or will use the NHS (that means nearly everyone in the country) then this question and answer session is worth watching.

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What is the number needed to treat (NNT)?

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Sometimes statistics are  like a sly old fox. They can be used malevolently to persuade members of the public about things they don’t know much about.

The pros and cons of breast cancer screening is in the news yet again today.

Probably every woman should look into this in depth but to help you first before you do, it is necessary to know the meaning of the Number Needed to Treat (NNT). Unless this is understood, people with a vested interest might run rings round you and you won’t know what to believe or worse still will believe the wrong thing.

Here is a brief account of NNT

COUNTRY: UK

This problem – and major problem it is – of not knowing who will benefit, and for that matter who will be harmed also lies at the heart of the screening debate, which has once again been re-ignited by a ‘new’ report on the benefits and harms of breast cancer screening, ‘new’ being qualified because, though the report is new, the data it is based on is old. The arguments for and against screening symptom free women of a certain age for breast cancer have gone up and down like a tired see-saw for decades.

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Crawling babies : coins and similar objects

A LOUD, (NOT WHISPERING) CONVERSATION WITH MY CHILDREN

The golden egg icon means I’m talking to my children. Sometimes I get ratty with them.

You have a baby who is on the verge of crawling and who wants to eat everything.

Why, why, why then do you leave coins lying about the floor and on low tables.

Don’t you know the diameter of a baby’s intestine in relation to that of a coin?

Don’t you know that coins don’t dissolve when they are swallowed?????


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Are health checks good for you?

It seems intuitive that it is a “good thing” to have regular health checks even if you are healthy. After all, you never know what beginnings of nasty diseases are lurking within you. Better detect these conditions early and so treat them early and perhaps save your life. Better to be safe than sorry. It is illegal not to have our cars MOT’d after all. And human beings are far more important than cars.

Hmmm……

A new Cochrane review published last week suggests otherwise.

GENERAL HEALTH CHECKS FOR REDUCING ILLNESS AND MORTALITY -FULL DATA

SHORTER VERSION

COUNTRY : INTERNATIONAL

General health checks involve multiple tests in a person who does not feel ill with the purpose of finding disease early, preventing disease from developing, or providing reassurance. Health checks are a common element of health care in some countries. To many people health checks intuitively make sense, but experience from screening programmes for individual diseases have shown that the benefits may be smaller than expected and the harms greater. One possible harm from health checks is the diagnosis and treatment of conditions that were not destined to cause symptoms or death. Their diagnosis will, therefore, be superfluous and carry the risk of unnecessary treatment.

We identified 16 randomised trials which had compared a group of adults offered general health checks to a group not offered health checks. Results were available from 14 trials, including 182,880 participants. Nine trials studied the risk of death and included 155,899 participants and 11,940 deaths. There was no effect on the risk of death, or on the risk of death due to cardiovascular diseases or cancer. We did not find an effect on the risk of illness but one trial found an increased number of people identified with high blood pressure and high cholesterol, and one trial found an increased number with chronic diseases. One trial reported the total number of new diagnoses per participant and found a 20% increase over six years compared to the control group. No trials compared the total number of new prescriptions but two out of four trials found an increased number of people using drugs for high blood pressure. Two out of four trials found that health checks made people feel somewhat healthier, but this result is not reliable. We did not find that health checks had an effect on the number of admissions to hospital, disability, worry, the number of referrals to specialists, additional visits to the physician, or absence from work, but most of these outcomes were poorly studied. None of the trials reported on the number of follow-up tests after positive screening results, or the amount of surgery used.

One reason for the apparent lack of effect may be that primary care physicians already identify and intervene when they suspect a patient to be at high risk of developing disease when they see them for other reasons. Also, those at high risk of developing disease may not attend general health checks when invited. Most of the trials were old, which makes the results less applicable to today’s settings because the treatments used for conditions and risk factors have changed.

With the large number of participants and deaths included, the long follow-up periods used in the trials, and considering that death from cardiovascular diseases and cancer were not reduced, general health checks are unlikely to be beneficial.

General health checks of people who are not complaining of disease is fashionable in many countries.

Even if useful, and this study suggests they are not, it is worth remembering that they make a lot of money for some and less money of others by keeping them employed. Are these good enough reasons for routine health checks (that may be associated with harms) on normal people?

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Cancer of the cervix : What does the Tampap Test reveal?

It must surely be a problem for patients when medical practitioners have different views about things.

Take for example a test known as the Tampap test. It does not detect cancer. Instead it detects the presence of HPV (human papilloma virus) in the vagina. Some strains of this virus can sometimes lead to cancer of the cervix, and so you might regard most types (well over 90%) of cervical cancer as a venereal disease caused by a virus. However it is not as straightforward as it seems.

Here is a video telling you all about it.

Two doctors, Dr Dawn Harper and Dr Christian Jenssen endorse it in the video.

Another doctor, Dr Margaret McCartney, has complained to the Advertising Standards Authority in the UK about the marketing used for this test and her complaints have been upheld.

She has written an article in The Guardian newspaper about it.

These three practicing doctors all have a media presence but the approach and style of the latter is very different from the two former doctors.

So what do you do when doctors seem to disagree?

Well I suppose you have to suss them out for yourself.

As well as studying their websites, the video referred to above might help you form an opinion about the two doctors who promote the test. So also might watching some of the TV programmes they have made.

A good way to suss out the doctor who made the complaint might be to read a book that she has recently published. It is aimed at the lay public but is full of interesting information that would benefit doctors as well as patients.

The Patient Paradox: Why Sexed Up Medicine is Bad for Your Health
By Margaret McCartney

Three doctors, demonstrating two very different ways of promoting health to their patients.

I’m pretty sure I’ve sussed them out.

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Making a Tippy Tap

TIPPY TAP

COUNTRY : WORLDWIDE

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Global Handwashing Day 2012

Today, 15th October 2012 is Global Handwashing Day.

“Human feces are the main source of diarrheal pathogens. They are the source of shigellosis, typhoid, cholera, all other common endemic gastro-enteric infections and some respiratory infections such as influenza and pneumonia. A single gram of human feces can contain 10 million viruses and one million bacteria.

These pathogens are passed from an infected host to a new one via various routes but all of these illnesses emanate from feces. Removing excreta and cleaning hands with soap after contact with fecal material –from using the toilet or cleaning a child – prevents the transmission of the bacteria, viruses and protozoa that cause diarrheal diseases.

Other measures (food handling, water purification, and fly control) have an impact on these diseases as well, but sanitation and handwashing provide the necessary protection against fecal contact. They start by creating initial barriers to fecal pathogens from reaching the domestic environment. Handwashing with soap stops the transmission of disease agents and so can significantly reduce diarrhea and respiratory infections, and may impact skin and eye infections.

Research shows that children living in households exposed to handwashing promotion and soap had half the diarrheal rates of children living in control neighborhoods. Because handwashing can prevent the transmission of a variety of pathogens, it may be more effective than any single vaccine. Promoted on a wide enough scale, handwashing with soap can be thought of as a “do-it-yourself” vaccine. Ingraining the habit of handwashing could save more lives than any single vaccine or medical intervention.”

GLOBAL HANDWASHING

COUNTRY : WORLDWIDE

Why Handwashing with Soap?
Handwashing with soap is the most effective and inexpensive way to prevent diarrheal and acute respiratory infections, which take the lives of millions of children in developing countries every year. Together, they are responsible for the majority of all child deaths. Yet, despite its lifesaving potential, handwashing with soap is seldom practiced and difficult to promote.

Turning handwashing with soap before eating and after using the toilet into an ingrained habit could save more lives than any single vaccine or medical intervention, cutting deaths from diarrhea by almost half and deaths from acute respiratory infections by one-quarter. A vast change in handwashing behavior is critical to meeting the Millennium Development Goal of reducing deaths among children under the age of five by two-thirds by 2015.

Global Handwashing Day focuses on children because not only do they suffer disproportionately from diarrheal and respiratory diseases and deaths, but research shows that children – the segment of society so often the most energetic, enthusiastic, and open to new ideas – can also be powerful agents for changing behaviors like handwashing with soap in their communities.

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Jimmy Savile : Beyond belief


Even though Jimmy Savile was a “benevolent” superstar, and even though he is now described as a “predatory paedophile,” it is beyond belief that he was put on a pedestal within hospitals and given the degree of access to patients to the extent that is being reported.

He was appointed as head of a task force to run Broadmoor, the high security psychiatric hospital. Why would they want him in that role? What qualifications did he have? Celebrity status? Large donations of money maybe?

JIMMY SAVILE SEX SCANDAL : GOVERNMENT TO INVESTIGATE BROADMOOR ROLE

They say he even had his own set of keys!

SAVILE HAD A SET OF BROADMOOR KEYS

He seems he might even have had a home from home at Stoke Mandeville hospital for spinal injuries.

STOKE MANDEVILLE HOSPITAL STILL HAS QUESTIONS TO ANSWER OVER THE JIMMY SAVILE CHILD ABUSE SCANDAL

He was even an Honorary Fellow of the Royal College of Radiologists.

SIR JIMMY SAVILE

Why? What contribution to the training of radiologists did he make? Money again perhaps. Maybe they should dismember the above link to this press release and stop being so sad.

It seems they are squirming now.

“Yesterday the Royal College of Radiologists squirmed over having made Savile an honorary fellow for his fundraising efforts. A spokeswoman said: “Had we been aware of these allegations at the time the RCR would not have had this association with him.”

Perhaps the Royal Colleges should concentrate on training doctors, and avoid being bribed by honouring non-medically qualified people who have not passed their exams but who have purchased their way in.

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National Health Action Party

A new political party has been born in the UK.

It is in response to the Health and Social Care Act which recently became law and which many believe will be the beginning of the end of the NHS as market forces take their toll.

It would be wonderful if a candidate could stand in every single constituency, and everyone who is ill, might become ill, or fears for the future healthcare of their children and grandchildren when they become ill, joins, supports or at least votes for this party during the next general election.

It would be even more wonderful if the party won the next election and a new Prime Minister was selected from their ranks.

Impossible?

Not really.

No political party had a mandate from the people of this country to govern during the last election.

There was no mandate for the Health and Social Care Act.

There was no mandate to unwind the NHS.

Supporting and voting for this party would make a very strong statement to every other major political party that they are not to be trusted with the healthcare of this country because priority is being given to business interests over health.

NATIONAL HEALTH ACTION


COUNTRY: UK

Welcome

The National Health Action party was formed by a group of like-minded healthcare professionals, who strongly support the original principles of the NHS and are shocked by the failure of the democratic process as demonstrated by the appearance and the passage through parliament of the Health and Social Care Act.

We believe the resulting legislation will destroy the NHS in England as an effective, efficient health system fair to all citizens and patients. It will transform a cost-effective public system of health care into one that will be more expensive, wasteful and unequal, whilst diminishing levels of public trust and corroding standards of ethical behaviour. Quite apart from the direct effects on healthcare provision, the destruction of the NHS also marks the violation of important social values. The NHS was more than just a structure for the delivery of healthcare. It was also a social institution that reflected national solidarity, expressed the values of equity and universalism, and institutionalised the duty of government to care for all in society.

The NHS marked out a space in society where the dictates of commerce and the market were held in check so as to give expression to socially directed goals, for individuals and society as a whole. Thus the NHS became the glue that holds together the social fabric of our nation. As the NHS is under so much threat, we believe that a new political party is needed to defend the NHS and its values, and we have therefore set up the National Health Action party.

We welcome members from all walks of life who value the NHS, not just NHS professionals.

P.S. If you have difficulty accessing this site today it is because it is receiving so many hits apparently!

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Reye’s Syndrome

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OK, it’s only a photo. These pills are yellow and aspirin is usually white. However, it is as well to remember as you travel around the world that some medications that don’t look like aspirin contain it as a component and unless you read the label carefully this could pass you by.

Why be concerned about aspirin? Introduced as an analgesic (painkiller), an antipyretic (ability to bring down fever), and an anti-inflammatory agent in 1897, it is one of the oldest drugs. It must have been a godsend for those suffering from toothache and other common aches and pains over a century ago. Aspirins’s chemical name is acetylsalicylic acid and it breaks down in the body to form salicylic acid.

It is an important drug in other ways and its benefits are today, over a century later, still being investigated.

However it also has side effects, the best known is that it can precipitate stomach bleeding.

There is also another rare but important side effect mainly affecting children. This has resulted in a change of advice to parents on how to treat a child with fever. In granny’s day it was normally advised to give a child half an aspirin to bring down temperature, however this is contrary to modern advice because of the possible risk of precipitating Reye’s Syndrome. Although this condition is rare, its seriousness is such that the risk of taking aspirin well outweighs any benefit in a child with pyrexia.

NATIONAL REYES SYNDROME FOUNDATION UK

COUNTRY : UK

What is Reye’s Syndrome

Reye’s syndrome is an acute disorder which affects children when they seem to be recovering from a viral illness like ‘flu’, chickenpox or diarrhoea. The child has a change in his/her personality or becomes drowsy and develops frequent or persistent vomiting. Unless diagnosed and treated successfully, death or severe disability may result.

Abnormal accumulations of fat develop in the liver and some other organs of the body. There is swelling of the brain which can cause it injury. The disease affects children from infancy onwards, including teenagers and has been reported, albeit rarely, in adults. Children of both sexes and all races can be affected.


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