Articles

NAPC GP Bulletin 8 August 2012

Cataract Surgery May Reduce Hip Fracture Risk

Older people who have cataract surgery may benefit from a reduced risk of hip fracture, new research suggests.

Scientists at the American Academy of Ophthalmology and the University of California, Los Angeles (UCLA) analysed the medical records of 400,000 patients who had cataract surgery to see whether they fractured a hip during the year after the procedure.  They also looked at patients who had cataracts but did not have them treated.

The researchers found that cataract surgery among people with vision loss was associated with a significantly reduced risk of fractures.  Overall the procedure was associated with a 16 per cent decreases in patients’ chances of having a hip fracture within a year.

Lead researcher, Dr Anne Coleman, from UCLA’s Jules Stein Eye Institute, said: ‘Our study suggests that people should never be regarded as too old to have their cataracts removed.  In fact, the greatest reduction in hip fracture risk was in patients who had cataract surgery when they were in their 80s.

Most people develop a cataract over time, as changes in the lens of the eye occur in the majority of over-65s.

One Million Cases Of Kidney Disease Go Undetected

According to a damning NHS report published on Monday, by NHS Kidney Care, doctors have failed to diagnose chronic kidney disease in more than one million people.

Treating kidney disease, including complications such as heart disease and stroke, costs about £1.4n a year, according to the report.  Nearly half of it is spent on kidney dialysis or transplants for patients whose disease has progressed so far that their kidneys fail.

About 1.8 million people in England have been diagnosed with chronic kidney disease; a further one million cases remain undiagnosed.

Cancer Treatment Set Back

Chemotherapy can backfire by helping healthy cells to fuel treatment-resistant cancer, research has shown.

The discovery by scientists in Seattle suggests that many forms of cancer treatment can actually make the disease tougher to tackle.

Gene Kills Cancer Of Prostate

British researchers have found a gene that can beat prostate cancer.  The gene, called Decorin, guards against tumours in the prostate gland. When it is faulty, carriers are in greater danger of developing the disease.

The Medical Research Council carried out the research with Prostate Cancer UK.  Dr Axel Thomson said: ‘This could mean that in future measurement of Decorin levels could become a reliable diagnostic test for prostate cancer and also help determine how aggressive the disease is.’

Breakdown Of Oestrogen Linked To Fatal Lung Condition

An enzyme involved in the breakdown of oestrogen may play an important role in the onset of pulmonary arterial hypertension, a lung condition that can prove fatal.

Scientists at the University of Glasgow discovered that the lungs of mice with pulmonary arterial hypertension had elevated levels of an enzyme called CYP1B1, which breaks down oestrogen into harmful smaller molecules.  They also found that by lowering the levels of CYP1B1, they were able to reduce the severity of the disease.

Further studies on urine samples from mice with the lung condition revealed that they contained large amounts of a toxic by product of oestrogen, called 16a-hydroxyestrone.  The scientists verified their findings in humans by showing that lung samples from patients with pulmonary arterial hypertension all had elevated levels of the CYP1B1 enzyme.

Professor Mandy MacLean, professor of pulmonary pharmacology at the University of Glasgow’s Institute of Cardiovascular and Medical Sciences, said: ‘We think it’s an important discovery because drugs that target this protein already exist, so our discovery provides a real rationale to go on to test these drugs in human patients.’

The study, which is published in the journal, Circulation, was part funded by the British Heart Foundation.

Dr Shannon Amolis, the charity’s research adviser, said; ‘Many questions about this condition are still unanswered, and the next stage is to move on to examine this association more closely in patients.’

Patch Test That Could Replace Insulin Injections For Diabetics

A stick-on patch that blasts insulin through the skin could banish the need for daily injections for many diabetics.  The high-tech electronic patch contains enough insulin to last the patient several days.

When a hand held device, called a sonic applicator, is held over the patch, it fires sound waves that open up the pores in the skin and force the drug into the bloodstream more quickly.

A survey last year by the charity, Diabetes UK, showed one in three sufferers hid their condition from others and often failed to test their blood sugar levels or missed insulin injections in case they drew attention to themselves.  The sound wave patch could be a painless, discreet alternative.

Pumping Iron Can Cut Diabetes Risk By A Third

A study has found that lifting weights five times a week could cut the risk of type 2 diabetes by a third, and if combined with aerobic exercise, can cut it by almost 60 per cent.

Even small amounts of weight training countered type 2 diabetes, which affects about two million people in Britain, many of whom do not know they have the condition.

Staying Fit Stops Falls

Research has found that simple home exercises such as standing on one leg can reduce falls among the elderly by almost a third.

One in three people over 65 suffers a fall at least once a year, which costs the NHS up to £4.6 million a day.

A study of more than 300 people over 70 found that those who took part in an exercise plan developed by the University of Sydney improved balance and strength.

Care Watchdogs Failing To Stop Abuse

An independent inquiry has suggested that regulators, police and social services are not up to the task of stopping institutional abuse in private care homes for the severely disabled.

A report into the abuse scandal at Winterbourne View in South Gloucestershire found that owners put ‘profitability’ before humanity, leaving vulnerable patients ‘chronically under-protected.’

The report also criticised the Care Quality Commission, the health watchdog, police and social services as well as the NHS for failing to pick up warning signs about the treatment of patients.

Margaret Flynn, chair of Lancashire’s Safeguarding Adults Board, who investigated the scandal, said in her report, that the company, Castlebeck, who owned Winterbourne, put company profitability above decisions about effective and humane delivery of assessment, treatment and rehabilitation.  

Eleven former members of staff have admitted offences against patients.

Families Blocking Organ Donor Wishes

Families are unfairly blocking organ donation from dead relatives who wanted to give the gift of life, a leading ethics expert has claimed.

There are 7,555 patients waiting for a transplant in the UK, with more in need, who are too ill to go on the list.

Dr David Shaw, lecturer in ethics at the Faculty of Medicine, Glasgow University, said research suggests that 10 per cent of families refuse to allow donation of their dead relative’s organs, despite his or her wishes.