MEDICAL MATTERS

[Tizer]

There was a `buffered ibuprofen' which contained magnesium hydroxide which was intended to reduce the drug's bad effects on the stomach lining. However some trials showed that it caused even more stomach inflammation.

[Stanley]

I took 'enteric coated' aspirin for years.... Arthur Morrison recommended it.
See THIS BBC report of what looks like a miracle, a successful face transplant. What a life-altering transformation!

[Tizer]

Researchers at Bath University have devised a medical dressing that changes colour when it detects infection and could cut the unnecessary use of antibiotics....LINK

[Stanley]

Forget the ISIS attacks, read THIS completely objective BBC report on the news that really serious resistance to the most powerful; antibiotic we have is being undermined by its wholesale use in agriculture in China. The possible death toll as a consequence to these resistant organisms, if and when they spread, will make a few hundred killed here and there look like a pinprick. This report isn't exaggerated, it is a warning flag for what is happening now. We spend trillions on arms and neglect things like this.

[Tizer]

Stanley is right, this is the biggest and most immediate threat to humans. A second BBC report has already appeared here: Analysis: Antibiotic apocalypse
To supplement the BBC reports here is one from a more technical source:
`The Lancet Infectious Diseases: New gene that makes common bacteria resistant to last-line antibiotic found in animals and patients in China' LINK
A new gene (mcr-1) that enables bacteria to be highly resistant to polymyxins, the last line of antibiotic defence we have left, is widespread in Enterobacteriaceae [1] taken from pigs and patients in south China, including strains with epidemic potential, according to new research published in The Lancet Infectious Diseases. The mcr-1 gene was found on plasmids, mobile DNA that can be easily copied and transferred between different bacteria, suggesting an alarming potential to spread and diversify between different bacterial populations. "These are extremely worrying results. The polymyxins (colistin and polymyxin B) were the last class of antibiotics in which resistance was incapable of spreading from cell to cell. Until now, colistin resistance resulted from chromosomal mutations, making the resistance mechanism unstable and incapable of spreading to other bacteria,"[2] explains author Professor Jian-Hua Liu from South China Agricultural University in Guangzhou, China. "Our results reveal the emergence of the first polymyxin resistance gene that is readily passed between common bacteria such as Escherichia coli and Klesbsiella pneumoniae, suggesting that the progression from extensive drug resistance to pandrug resistance is inevitable."

This is a worldwide problem. Antibiotics have been mis-used globally for many decades. Scientists have been warning since the 1960s that bacteria would become resistant if the medical profession continued wrongly prescribing antibiotics and if they continued being used widely in agriculture. But, as with climate change, warnings have been ignored and vested interests have had far too much influence.

We urgently need to seek new ways of controlling bacterial infection and curbing the mis-use of antibiotics and antibacterials. And it has to be a global project, just as tackling climate change and terrorism needs a global approach. Probably the single most critical need today is for governments to stop bickering and to start collaborating.

[Stanley]

I saw an interview on TV yesterday with a very impressive lady epidemiologist who said that based on previous experience it took four years for the resistant organisms to escape into the rest of the world and six years until they arrived here. This of course is calculated from the time when they reach critical mass... She persuaded me!

[Tizer]

`GPs urged to report unfit drivers to DVLA' BBC, 25 Nov 2015 LINK
Thank goodness for that. I wish they'd done it when my dad was refusing to give up driving, his GP wouldn't do anything about it even though he was a geriatric specialist!

[Stanley]

Only 'urged' Tiz. A step too far to make it a statutory duty. A black day for elderly retired couples for whom a car is essential....
I had my foot inspection and blood taken yesterday for a diabetes assessment. I thought they were about due.... I shall drop my urine sample in today so they have all the results before the assessment. I'm interested to see if there is any improvement after losing over 20lbs......

[Tizer]

A black day for elderly retired couples for whom a car is essential....

But as you say, it's only `urged'...and it's only if they are unfit to drive.

[plaques]

I'm interested to see if there is any improvement after losing over 20lbs.

Here's something that may interest you. Diabetes . You only have to lose 1 gram providing you lose it from the right place. General weight loss can stimulate fat being lost round the pancreas resulting in an improvement of the insulin supply.

[Stanley]

Thanks P. Yes it can be very good in borderline cases, we will see next Thursday how I am doing now....
Have a look at THIS. My grand daughter Laura is off to have a spell with them next week. She is at university doing a degree to qualify as a paramedic so she should be useful......

[Tizer]

Plaques, thanks for posting the link to the pancreatic fat study. It's interesting but I have some reservations about the way it's being reported and the conclusions, so looked at the university's own press release: Newcastle University

After reading that I'm still unhappy about the claims. For example, they say: "In patients who had started with Type 2 diabetes, fat levels in the pancreas (pancreatic triglyceride) decreased by 1.2% over the 8 weeks....With an average pancreas for a person with Type 2 diabetes having a volume of 50 ml, this is the equivalent of around 0.6 grams of fat." You're probably better at maths than I am but I think that if a decrease of 1.2% equates to 0.6g then 100% (ie. the total fat content of the pancreas) must be 50g. But they say the volume of the pancreas is 50ml! I suspect they're making the mistake of confusing `percentage' with `percentage units' which makes me a bit queasy about the rest of their claims.

I read elsewhere (LINK) that the fat content of the pancreas of people not suffering from diabetes is about 10% and of Type 2 diabetes patients about 20%. So I guess what they meant to say was that in the diabetes patients the fat content fell from about 20% to 19%.

Also, I'm not convinced they have proved that the loss of pancreatic fat and the `curing' of diabetes isn't simply a coincidental association. However, there is already evidence that increased pancreatic fat may impair the beta cells of the pancreas (see my link above) so let's hope they are right and that these studies benefit diabetes patients.

[plaques]

I agree Tizer its confusing and I must admit I don't really understand the figures. One thing I can say is that after seven weeks of intensive hospital visiting, four different hospital and numerous wards. My general observation was that the patients who were really suffering and making slow recoveries were the overweight ones. Getting rid of excess weight seems to be a priority in all cases.

[Stanley]

I agree P that the major improvement is gained by reducing weight. It benefits all aspects of health and could be the coincidental factor that Tiz refers to. It seems to me a given that if you reduce pancreatic fat you reduce internal fat overall and this is definitely a good thing. I seem to be lucky in that when I reduce my weight it's my stomach that shrinks. I take this to mean that I am reducing my internal fat to a greater extent than ordinary subcutaneous fat on the rest of my body.... What is certain is that I am benefiting from this regime, that'll do me!

[Stanley]

I heard a doctor recommending statins this morning on World Service. He said they were a valuable life-style choice.... He also said that the evidence in favour of them was overwhelming. A very dangerous claim to make......

[Tizer]

The `evidence in favour' is probably a narrow view of the effectiveness in reducing heart disease in a population without taking into account side effects.

[Whyperion]

I'm interested to see if there is any improvement after losing over 20lbs.

Here's something that may interest you. Diabetes . You only have to lose 1 gram providing you lose it from the right place. General weight loss can stimulate fat being lost round the pancreas resulting in an improvement of the insulin supply.

What I dont wholly understand is my father-in-law with very little waistline fat (you probably could have posted him down a gulley grating) had about 20years of diabetes, but my now natural waistline (I used to be less large when I cycled - the heath benefits of which I doubted after bits of me got re-written by a motorcyclist), expands to a rather excess level, despite additional periodic excercise , yet I dont have diagnosed diabetes).

[Stanley]

My main problem with research is that the results are all based on Mr or Mrs Average. Some of us aren't average!
Daughter Margaret reminded me yesterday I had a wheat bag which she gave me a long time ago. I'd forgotten I had it. They are brilliant for applying l;ocal heat after warming up in the microwave.... (What's that red thing perched on Stanley's shoulder?)

[Tizer]

Whippy, as Stanley says, it's often due to natural variation. The health advisers would like us all to conform to the average, it would make their lives easier!

[Stanley]

I think I may be a variant.....
Arm continues to improve slowly, still giving it TLC!

[Tizer]

Well at least you didn't say you were a deviant!

[Stanley]

I nearly did Tiz....
I came to a decision last night. I am going to stop doing TLC and crack the whip! I shall be in the shed this morning. It's too easy to get to the stage where you convince yourself you are poorly when all that's wrong is that you aren't active enough..... I could be wrong of course but I shall give it a try.

[Tizer]

`Anti-depressants 'no more effective than counselling''
"Anti-depressants are no more effective than counselling in tackling depression, a BMJ study has found. The research comes amid soaring levels of prescribing of the drugs, with a doubling in the numbers doled out in the last decade. Researchers examined 11 trials which compared modern antidepressants such as Prozac with psychological approaches, usually involving cognitive behavioural therapy (CBT). The study found no statistical difference between drugs and therapy when it came to their effectiveness for moderate to severe depression. The UK now has the seventh highest prescribing rate for antidepressants in the Western world, with around four million Britons taking them each year - twice as many as a decade ago. ".... Daily Telegraph

[Stanley]

I heard a discussion on that yesterday on R4. What struck me was that the expert being interviewed said that in his experience, the most effective therapy was the one the patient preferred. Problem is that it's easier to get access to the pills than cognitive therapy.....
Did you see the report on the fact that GPs who tighten up prescription of antibiotics have more disgruntled patients than those who hand them out like toffees?
Diabetes clinic this morning. I will be interested to see if my weight loss has had any effect on what they describe as my 'Stubborn blood sugar levels'. My argument is that as the reading is stable and I am perfectly healthy it may be that this is simply the level my body chooses to work at. I shall get a print out of the analysis.....

[Wendyf]

Do take care with your blood sugar levels Stanley, the damage that high levels do to your body can be devastating.
On the subject of diabetes, I came across LADA or type 1.5 diabetes yesterday - see THIS on the Diabetes UK website. It could explain Colin's experience of diabetes. He is going to ask for a blood test.