NAPC News 5 February 2010

News From NAPC

This week saw meetings of the Executive Committee and NAPC's Council. The latter was attended by Sir David Nicholson. There was a lively discussion about the financial challenge that lay before the NHS. Each year since the war overall there had been an average increase in budget allocations of in excess of 4%. The NHS had no experience of zero growth.

There then followed some discussion about the recent guidance on community services, which, members pointed out, would mean that practices would be unable to deliver care closer to home and foster early discharge from hospital at lower cost while improving quality.

There was also further debate about practice boundaries. Some of the difficulties were pointed out for patients when these crossed PCT and other boundaries.

Two Oral MS Drugs Shown To Cut Relapses

Two oral drugs being investigated as possible treatments for MS have shown significant reductions in relapse in three new studies. The drugs also showed manageable adverse event profiles, researchers said.

Cladribine and fingolimod were both found to be highly effective against placebo over two years. Fingolimod was also shown to be more effective than intramuscular interferon beta -1a over 12 months.

Writing in the New England Journal of Medicine (NEJM), Professor Gavin Giovanonni from Barts and the London School of Medicine and Dentistry, who led the cladribine study, said the introduction of an oral therapy, particularly one that had no short-term side effects and was as easy to use as oral cladribine, would have a major impact on the treatment of MS. However, he added that the potential long-term side effects had to be defined before advocating first line use of the drug.

The Super Pill That Helps People Live Past 100

Scientists are on the verge of developing a pill that could help people live past 100, according to experts. The drug, which is designed to mimic the actions of three genes that aid longevity, could be ready for testing within three years. Two of the genes increase the production of so-called good cholesterol in the body, reducing the risk of heart disease and stroke, while the third helps to prevent diabetes. People with the gene variants are also 80 per cent less likely to develop Alzheimer's disease, the study indicated.

Children's Health Worse Than A Decade Ago

Children aged under five have worse teeth and are more likely to be overweight than they were a decade ago, despite nearly £11billion of investment, a study has found. Dental health has worsened and obesity rates have risen. The average fiver year old in 2005/6 had 1.47 decayed, missing and filled teeth, compared with 1.43 in 1999/2000. Childhood obesity rose from one in ten to one in seven between 1995 and 2008, although the rated of growth many now be slowing, the report said.

Dementia Is Nation's Greatest Health Challenge

Dementia is the greatest health challenge of our generation, a charity has warned. More than 820,000 people have the condition, costing the economy £23 billion a year, according to a report from Oxford University, which also found that dementia cost more than heart disease and cancer combined.

The study, commissioned by the Alzheimer's Research Trust, found that despite this fact, Britain spends £590 million a year on cancer research and £169 million on heart research while dementia only receives £50 million.

Blood Test For Cot Death Risk

Scientists hope to develop a blood test to identify babies most at risk of cot death, after finding changes in the way some infants sleep. Research has suggested that babies who died of cot death had low levels of the hormone serotonin in their brains. The hormone controls sleep and breathing patterns.

Researchers at Harvard Medical Schools said babies with low serotonin levels may not wake up of change position when their breathing was impaired by sleeping on their front, for example. Serotonin levels were 26 per cent lower in babies who had died of cot death compared with those who died from other causes.

Fish Oil Supplements May Treat Mental Illness

People who face an extremely high risk of developing psychosis my benefit from taking fish oil supplements, new research suggests.

Scientists found that individuals who took fish oil supplements for 12 weeks were less likely to develop psychotic disorders during that time.

The team, who were based at the Medical University of Vienna and Orygen Youth Health Research Centre in Melbourne, recruited 81 volunteers, all of whom were deemed to be at particularly high risk of psychosis. Of theses, 41 were given daily fish oil supplements for 12 weeks, while the remainder took a placebo.

By the end of the 12 week period, 11 people in the placebo group had transitioned to psychotic disorder, compared with just two people in the omega-3 group.

Writing in the Archives of General Psychiatry, the study authors pointed out the benefits of preventing full-blown psychotic disorders. They observed that the finding that a treatment with a natural substance might prevent or at least delay the onset of psychotic disorder gave hope that they might be alternatives to anti-psychotics for the prodromal phase. This could avoid the metabolic changes, sexual dysfunction and weight gain that were often experienced by those taking anti-psychotic medicines.

Injection May Relieve Chronic Pain Condition

Scientists have discovered that an existing treatment designed to dampen inflammation may be beneficial for people with a rare chronic pain condition. Intravenous immunoglobulin (IVIG) is already used to treat some immune diseases and the latest research from the University of Liverpool suggests it might also reduce the severe burning sensation associated with complex regional pain syndrome (CRPS). This is a condition that sometimes develops after an injury to a limb and persists even though the original injury has healed.

Although the condition is hard to diagnose, one study cited by the NHS Choices website estimated that CRPS occurs after on in every 2,000 incidents of injury or trauma.

Researchers at the University of Liverpool found that nearly half of patients treated with IVIG reported a significant improvement in pain, typically lasting for around five weeks. However, the treatment is not currently approved by the National Institute for Health and Clinical Excellence for use in patients with CRPS.

Dr. Andreas Goebel, whose findings are published in the Annals of Internal Medicine, commented that the discovery was expected to have a real impact on the treatment of other unexplained chronic pain conditions. He suggested that the treatment might even be more effective than in the study, as it could be given in higher doses at regular intervals.

Poor Memory Linked To Greater Stroke Risk

Older people who experience memory loss may face a heightened risk of stroke, new research suggests.

Swedish scientists studied 930 men, all of whom were around the age of 70 and were required to complete three mental tests. They found that those who performed worst in a test designed to measure a person's ability to execute and modify a plan were three times more likely to have a stroke or brain infraction, the most common cause of stroke, during a 13 year period than those who performed the best.

Study author, Dr Bernice Wiberg, from Uppsala University, commented that stroke was a leading cause of disability and death among older people, making early identification of people at high risk of stroke extremely important so preventative measures can be taken.

The results support the idea that cognitive decline, regardless of whether a person had dementia, may predict risk of stroke, Dr Wiberg said. The findings are published in Neurology journal.

When Exercise Is A Waste Of Time

Researchers have found that the health benefits of aerobic exercise are determined by our genes and can vary substantially between individuals. About 20 per cent of the population gain no significant benefit from regular exercise, according to an international study reported in the Journal of Applied Physiology. Such people should focus on other ways of staying healthy, such as improving their diet or taking medication.

3D Scans May Put Baby At Risk

Taking 3D pictures of unborn children could put the foetus at risk, experts warned this week. The Health Protection Agency said there had been some unconfirmed reports suggesting possible effects on the developing nervous system from ‘non-essential' ultrasound scans. Parents should be award of possible risks of ‘souvenir foetal imaging' scans, such as creating 3D images of a baby, which do not have a ‘defined diagnostic benefit'.

Proof Of Life In The Walking Dead

Patients left in a vegetative state after suffering devastating brain damage are able to understand and communicate, ground breaking research suggests. Using brain scans, it indicated for the first time that some victims, who showed no outward signs of awareness, could not only comprehend what people were saying, but could also answer simple questions.