The hidden dangers in fruit juices

By: Ross Chainey, MSN UK HEALTH
Wed Aug 06, 2008

Fruit juices:

Britons consume more than two billion litres of fruit juice every year; that’s 36 litres each.

And we all enjoy fruit juice under the impression that, as one of our ‘five-a-day’, it’s doing us a world of good.

But the journal Diabetes Care found, after monitoring the eating habits of more than 70,000 nurses of an 18-year period, a glass of orange juice a day raised the risk of developing type-2 diabetes by 24%.

Eating whole pieces of fruit, however, can reduce the risk by as much as 18%.

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Red Bull: it promises energy, but doesn’t mention sticky blood…

By: The Independent
Sunday, 17 August 2008

Australian researchers have found that the sugar-free version of Red Bull,launched in 2003, may increase the danger of blood clots, and creates “sticky” blood, raising the risk of heart attack or stroke.

How this affects the sales of Red Bull – last year 3.5 billion cans were sold in 143 countries – is yet to be seen.

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Moisturisers ‘raise skin cancer risk’ …

By: Jeremy Laurance, Health Editor, The Independent
Thursday, 14 August 2008

Moisturisers used by millions every day may be increasing the risk of common skin cancers, scientists have warned.

Most such creams have never been tested for their cancer-causing effect on the skin. Now scientists have found that they increase the carcinogenic effect of sunlight in mice.

Experiments on mice had shown that when caffeine was given orally or applied direct to the skin, it appeared to inhibit cancer.

The significance of the findings for humans has still to be established, the team reports in the Journal of Investigative Dermatology.

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Management of postnatal depression, a clinical review

By: Charles Musters, specialist registrar in perinatal psychiatry, Elizabeth McDonald, consultant in perinatal psychiatry and Ian Jones, senior lecturer in perinatal psychiatry.
BMJ, 8 August 2008

• Postnatal depression occurs after 13% of births.
• The nature of the puerperal trigger is still unknown, but several psychological, social, and biological factors probably play a part. Genetic factors have been implicated
• A previous history of postnatal depression or of any mental illness, poor social support, and depression during the pregnancy all increase the risk of developing the illness
• Postnatal depression needs to be identified and treated promptly and adequately because it can result in a range of lasting adverse outcomes for mother and child
• A range of psychological therapies is effective in treating postnatal depression
• Drugs are also effective and some antidepressants are thought to be safer in breastfeeding mothers than others. But in general the long term outcomes for exposed babies are unknown. Although tricyclic antidepressants have been prescribed for longer, most recent reproductive safety data, which include thousands of exposures, have been for selective serotonin reuptake inhibitors. Because of concerns about toxicity, tricyclics are prescribed less often than selective serotonin reuptake inhibitors for postnatal depression.
• Drugs are recommended for women who decline psychological therapy, or for whom there would be an unacceptable delay in providing non-pharmacological measures.

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NHS trusts face fines for poor hygiene of up to £50,000 …

By: Jeremy Laurance, Health Editor, The Independent
Tuesday, 12 August 2008

Fines of up to £50,000 will be imposed on NHS trusts which breach hygiene regulations in a crackdown on hospital infections.

Inspectors will have powers to prosecute dirty hospitals and clinics, and impose sanctions ranging from fixed penalty fines to closure of wards, clinics or services.

The fresh measures are part of the Government’s drive to protect patients against superbugs, including MRSA and Clostridium difficile.

Public anxiety has been increased by incidents such as the 90 deaths attributed to C. difficile at Maidstone and Tunbridge Wells NHS Trust over two and half years. The deaths of a further 255 patients were judged to have been hastened by the bug.

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Chlamydia drug to be sold without prescription …

Source: Medicines and Healthcare products Regulatory Agency, Press release
Wed 6.8.2008

The Medicines and Healthcare products Regulatory Agency (MHRA) has today given approval for a medicine to be made available from a pharmacist without a doctor’s prescription to treat chlamydia.

The azithromycin pill, which will be called “Clamelle”, will be available to buy by people 16 years and over if they have tested positive for the infection and have no symptoms, and for their sexual partners.

Dr June Raine, Director of Vigilance and Risk Management of Medicines at the MHRA said, “Chlamydia is the most common sexually transmitted disease in the UK.

Up to 70% of people who have chlamydia have no symptoms and could therefore remain undiagnosed. This means that they are at huge risk of serious long-term health complications, including infertility and ectopic pregnancy.

The medicine is expected to hit pharmacy shelves later this year.

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Can it ever be right for the NHS to reject drugs that could extend life?

Click on the picture to enlarge …

By: Jeremy Laurance, Health Editor, The Independent
Friday, 8 August 2008

“Why are we asking this now?

Cancer charities, kidney specialists and campaigners were outraged yesterday when the National Institute for Clinical Excellence (Nice), announced that it had rejected four new drugs for advanced kidney cancer as too expensive for the NHS.

In draft guidance, the medicines watchdog said that the drugs can extend life by five to six months on average but they cost too much. The money would do more good if it were spent elsewhere in the NHS, it said.

Surely the NHS should provide these drugs?

Of course they should.
So why wouldn’t Nice give the go-ahead?
Because, it said, the drugs were not “cost-effective”.

What do the drugs cost?

Between £20,000 and £35,000 per patient per year. But that is only half the story. We also need to know how much benefit they bring.

Why are the drugs so expensive?

This is the question that dare not speak its name. It is incomprehensible that the manufacturers of the four drugs have so far escaped criticism. They are charging astronomical prices for drugs that offer little benefit – in effect, holding a gun to the heads of kidney cancer sufferers and saying to the NHS: “Give us the money or we shoot.”

So did Nice do the wrong thing?

Yes…:

* Patients in need of these drugs have few other options available to them

* Expensive or not, other European countries find the funds to provide the drugs

* It is inhumane to deny anyone the chance of living longer, even if the drug is not a cure

No…:

* They are too expensive for the benefit they deliver, which is not ultimately life-saving

* This is a zero-sum game: a pound spent on one patient is a pound denied to another

* It is unrealistic to expect every drug to be approved: the NHS budget is not unlimited

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Hypothyroidism in adults

Thyroxine structure

By: Bijay Vaidya, consultant endocrinologist and honorary senior clinical lecturer and Simon H S Pearce, professor of endocrinology and honorary consultant physician, Newcastle upon Tyne.
BMJ 28 July 2008

Hypothyroidism is one of the commonest chronic disorders in Western populations. In the United Kingdom, the annual incidence of primary hypothyroidism in women is 3.5 per 1000 and in men 0.6 per 1000.

The management of hypothyroidism is generally considered straightforward and is mostly carried out in primary care in the UK. Cross sectional surveys of patients taking levothyroxine have, however, shown that between 40% and 48% are either over-treated or under-treated.

Furthermore, a small but significant proportion of patients continue to feel unwell despite taking levothyroxine.

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The hidden dangers in organic vegetables

By: Ross Chainey, MSN UK HEALTH
Wed Aug 06, 2008

Think because you’re buying organic your food is chemical free?

Think again.

Under Soil Association regulations, a select number of sprays are still permitted to be used, and thousands of tons of organic vegetables sold in this country every year are produced using toxic pesticides, despite shoppers paying extra for natural produce.

For example, figures show that a third of UK organic potato farmers last year sprayed their crops with fungicides made with copper, a heavy metal that can cause liver disease.

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Obesity does not limit benefits of knee replacement

By: Roger Dobson
BMJ, Published 31 July 2008

Clinically obese people can benefit almost as much as anyone else from knee replacement surgery, research has shown (Annals of the Rheumatic Diseases 2008; doi 10.1136/ard.2008.093229).

The findings show that there is little justification for policies that deny this type of surgery to obese patients on the grounds of their body mass index (BMI).
BMI should not be a contraindication, provided that the patient is sufficiently fit to undergo the short term rigours of surgery.

However: Obesity is obviously a strong risk factor for developing knee osteoarthritis.

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