NAPC News 13 August 2010

NAPC News

Works continues on conference arrangements for October, which is promising to be a hugely successful and exciting event. Book now to ensure you have a place, as booking is heavy.

Further inter-primary care meetings took place with other leading organisations and most of the Executive is preparing to go on holiday for their well deserved breaks.

Work has begun on dealing with the Department of Health consultation documents. If you have any views about which you feel strongly and would form a helpful part of a response to any of the consultation documents, please do let Maggie Marum here know at This e-mail address is being protected from spambots. You need JavaScript enabled to view it Your views are very important to us, and to the Department of Health, so please let us know your specific views in relation to specific questions raised in the consultation document.

There will be no news for the next two weeks.

Spinal Cord Regeneration Success In Mice

US researchers have for the first time encouraged substantial re-growth in nerves controlling voluntary movement after spinal cord injury. By manipulating an enzyme involved in cell growth, researchers were able to regenerate spinal cord nerves I mice, Nature Neuroscience reported. It follows similar work on repairing the optic nerve to restore sight.

UK experts have said the next challenge would be to convert the findings into a treatment suitable for humans. The ability to grown new nerve cells is present at birth but diminishes with age. It means that after injury or illness to the spine, such cells known as axons, cannot regenerate.

In the latest study, the researchers attempted to switch back on the signaling pathway that encourages this new growth in young mammals. They did it by knocking out a gene called PTEN in mice, which in normal circumstances puts a halt on new nerve growth.

The team, from Harvard Medical School and the University of California, Irvine, reported substantial re-growth in several spinal cords in animals. They are now working on tests to see if the technique can actually restore spinal cord function.

Dr Michael Coleman, from the Babraham Institute in Cambridge added that the challenge would be taking the results and turning them into a treatment that could be used in humans. Finding drugs to block the same pathway would be one approach as even gene therapy, which was highly experimental, could not easily ‘remove' a gene as they had in the study.

Pain Relief Revolution For Operations In Swansea

Doctors in Swansea said they have transformed the way they carry out complex operations by using a new nerve block instead of general anaesthetic. By targeting imjections using ultrasound, patients who would have needed days in hospital can have surgery and be sent home within hours.

The pain relief technique is currently being used for hand and arm operations. The local health board said the process saved money and created less risk for patients.

The nerve block, a regional anaesthesia, has been developed in the day surgical unit at Singleton Hospital. It is different to a local anaesthetic in that it works on the nerves affecting the whole arm, rather than a part of it. It is also stronger and the effects continue after the operation, giving additional pain relief for about 12 hours.

As a result, the patient remains fully conscious throughout surgery and goes home within half an hour of surgery, instead of being an inpatient for two to three days, following general anaesthetic.

These new arrangements showed saving of between £350 and £650 per session, aside from the money saved by a patient not being in a hospital bed for several days.

Diabetes and Literacy Key To Beating Dementia

Preventing diabetes and depression could have a dramatic impact on cutting cases of dementia, a study suggested.

Boosting levels of education and upping fruit and vegetable consumption would also have a big effect, the British Medical Journal said. It comes as another study showed that dementia patients were missing out on vital early treatments because GPs are being slow to diagnose them.

It is estimated that one million people in the UK will have dementia by 2025. Several risk factors for the disease have been identified, including obesity, high blood pressure and high cholesterol.

However, British and French researchers wanted to assess what public health interventions could have the biggest impact on reducing the burden of dementia in the population.

They took a group of 1,400 elderly people and tested them for signs of dementia after two, four and seven years.

Alongside this they recorded height, weight, education level, monthly income, mobility, dietary habits, alcohol consumption, and tobacco use and asked participants to do a reading test as a measure of intelligence.

Eliminating depression and diabetes and increasing fruit and vegetable consumption were estimated to lead to an overall reduction in new cases of dementia. Increasing education would also lead to an estimated 18% reduction in new case of dementia across the general population over the next seven years, they reported.

By contrast, removing a gene linked with the disease would only cut new cases by 7%.

The team concluded that early screening for diabetes and treatment of depression would be the most useful approach for trying to reduce the future burden of dementia. They added that encouraging literacy at all ages and trying to increase population intake of fruit and vegetable, would also have an important effect, but admitted that these aims were more difficult to implement.

Further studies including younger adults are needed to test the impact of such approaches, they added.

In the second study, also in the BMJ, analysis of health records of over 135,000 people in the UK found that people with dementia were three times more likely to die in the first year after diagnosis than those without the condition, which suggests that diagnoses are being made in later stages of the disease.

Professor Clive Ballard, Director of Research at the Alzheimer's Society said a healthy lifestyle was the key. Effective prevention of diabetes, depression and heart disease could potentially improve the lives of millions of people affected by Alzheimer's and reduce the billions spend on dementia care each year.

Dr Victoria King, Head of Research at Diabetes UK, said there was a growing body of evidence suggesting a link between diabetes an Alzheimer's disease.

Tongue Piercings Can Cause Damage To Teeth

People with tongue piercings risk developing gaps between their front teeth as a result of playing with the stud, US researchers found.

The University of Buffalo team said that, as well as potentially requiring cosmetic work, people could develop infections and chipped teeth. The researchers discussed a patient in the Journal of Clinical Orthodontics, who needed braces to correct the gap in her teeth. The researchers said that people with tongue piercings were likely to push the metal stud up against their teeth and consequently cause gaps and other problems to arise. And they concluded that tongue piercings could result in serious injuries, not just to teeth. Piercings have also been associated with haemorrhages, infections, trauma to the gums and, in the worst cases, brain abscesses.

GPs Overlook Public Health For QOF Cash

The quality and outcomes framework has resulted in GPs focusing too narrowly on certain conditions to the detriment of their wider public health role, the King's Fund has warned.

King's Fund head of policy, Anna Dixon, said research on the QOF, due to be published before the end of the summer, had revealed concerns about how GPs viewed public health.

She said that while they would all recognise that GPs have a very important role, research suggested that even in deprived practices many did not really see their role in tackling health inequalities.

The research - a joint project with the London School of Hygiene and Tropical Medicine - looked at the impact of QOF on public health and public health outcomes, variations between practices and the potential for the framework to help meet targets on public health and health inequalities.

Ms Dixon said the research showed performance gaps between practices serving deprived and non-deprived areas had ‘pretty much disappeared', but went on to say that the findings suggested that GPs should in future be held to account for broader public health outcomes.

New Superbug Raises Medical Tourism Fears

Hospitals are on the alert for an antibiotic resistant superbug imported by people who have had cosmetic surgery abroad. Almost all antibiotics fail to treat it and scientists say it has alarming potential to spread and diversify. 17 of the 37 Britons who have already been affected had had direct contact with India or Pakistan, and 14 had visited for cosmetic surgery. The findings will add concern over the rapid spread of superbugs resistant to most forms of treatment, and deal a blow to the nascent trend of medical tourism, by which patients travel abroad to seek cheaper treatment or access medical services refused in their own countries.