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BBC Radio 4 - Medical Matters

Inside Health

Dr Mark Porter demystifies health issues, separating fact from fiction and bringing clarity to conflicting health advice, with the help of regular contributor GP Margaret McCartney

Inside Health

  • Blood pressure pills and cancer, Aortic aneurysm repair, Sinks and hospital infection
    Clarity behind recent headlines linking cancer to pills for high blood pressure; Margaret McCartney unpicks the numbers. And the aorta is the largest artery in the body so should it burst due to an abdominal aortic aneurysm, results can be catastrophic. Now Surgeons are concerned that restricting the use of the latest keyhole techniques to repair aneurysms would be a backward step and harm patients. Plus how sinks could be causing hospital infections.

  • Epipens & Autoinjectors; Meningitis B Bedside Test; Age Related Macular Degeneration
    Adrenaline auto injectors are used to treat life-threatening allergies, anaphylaxis, but there are severe supply issues with the brand leader, epipen, particularly with junior epipen and many parents are reporting problems when their children's devices need replacing. It's an anxious time for those caring for severely allergic children and Dr Margaret McCartney reviews the reasons for the shortage and the latest advice for worried parents. At the same time, epipen has come under fire from a UK coroner, who concluded during an inquest into the death of 15 year old Natasha Ednan-Laperouse, that epipens aren't fit for purpose because they don't contain enough adrenaline or have a long enough needle to deliver it properly. Consultant paediatric allergist at St Mary's Hospital, London and a researcher in children's allergies at Imperial College, Dr Robert Boyle, tells Mark there is widespread belief that the companies behind adrenaline auto injectors need to innovate and better designs are needed. Meningitis is every parent's nightmare. It can strike anyone at any age but around half of those with the most serious form, Meningitis B, are toddlers and young children. Two years ago, Ezra, who is now three and a half, contracted the disease. His parents, Cosmin and Serena from Carrick Fergus in Northern Ireland, tell Inside Health how this devastating illness spread so rapidly. Ezra's life was saved but septicaemia meant both of his legs, below the knee, were amputated, followed by the fingers on one of his hands. One of the paediatricians who looked after Ezra at the Royal Belfast Hospital for Sick Children was paediatrician Dr Thomas Waterfield. Inspired by Ezra, Tom worked with colleagues at Queen's University in Belfast to develop a rapid bedside test for Meningitis B. The LAMP test - Loop Mediated Isothermal Amplification test - takes just an hour to identify the Meningococcal DNA and it doesn't need specialists to use it. The current lab test for the disease takes a minimum of 48 hours. Age related macular degeneration, AMD, is the leading cause of blindness around the world, with at least half a million people living with this condition in the UK alone. Treatment has hugely improved in recent decades, with regular injections helping to prevent progressive loss of vision. But intensive monitoring is necessary with monthly trips to hospital for patients for vision tests. Researchers at the Centre for Public Health at Queen's University, Belfast, are trialling ways to avoid these regular hospital visits - saving patients the journey and saving the NHS money. The Monarch Study will assess different ways that patients can monitor their own vision at home, using paper tests or more sophisticated ipad-style eye tests. Mark meets Patricia, who has wet AMD in one eye and dry AMD in the other, who's agreed to be part of the trial and talks to research optometrist Lesley Doyle and Chief Investigator, Dr Ruth Hogg, about the study. Producer: Fiona Hill

  • France Delists Alzheimer's Drugs, Quality of Life After Hip Fracture, Prostate Cancer
    France delists Alzheimer's drugs, a move that is a world first, after concluding that the dangers of side effects outweigh any benefits. Mark assesses the evidence and hears the arguments from France and the UK including from the head of drug evaluation at the French Health Authority which is behind the decision. Plus a more holistic approach to hip fracture and a visit to a busy clinic in Oxford where research measuring quality of life after surgery aims to improve outcomes that really matter to patients. And Margaret McCartney on prostate cancer and the Stephen Fry effect

  • Placebo on Prescription: Hepatitis C Transplants, Genes and Back Pain
    Until recently it was assumed that placebo pills would only produce a therapeutic benefit if patients didn't know that's what they had been given. But there are early suggestions that patients can still get symptom relief even when they're told that there is no active ingredient at all in the pills they've been given. So should placebo pills be openly prescribed to patients? Ted Kaptchuk, Professor of Medicine at Harvard University tells Mark he believes open-label placebo could, if evidence continues to accumulate, form part of the physician's therapeutic toolbox. But Inside Health's Dr Margaret McCartney urges caution. She says there is insufficient evidence about the long-term impact on symptoms. Nearly 500 people died on the transplant waiting list last year and if you're one of the 7,000 waiting for a life-saving organ, how would you feel if the organ on offer came from a donor infected with hepatitis C? Such organs are about to be available on the NHS and this radical change has come about because of the revolution in treatment for this potentially-serious blood borne viral infection. Yes recipients of Hepatitis C positive organs will be infected by the virus after transplant, but a short course of treatment, direct acting antivirals, will then cure them. Consultant kidney and transplant specialist Dr Adnan Sharif from Queen Elizabeth Hospital in Birmingham explains why patients on the waiting list should have this option available to them and Professor James Neuberger from the UK government's advisory committee on the Safety of Blood, Tissues and Organs, tells Mark why SaBTO have recommended this policy change and are now keen to see it implemented. Back pain is common but most of us recover in a matter of weeks. For 10-20% of people though, the pain and discomfort doesn't go away and they suffer chronic pain throughout their lives. What many people don't know is the extent to which genes feature in back pain - it runs in families. Frances Williams is Professor of Genomic Epidemiology at Kings' College, London and a consultant rheumatologist at Guy's and St Thomas' NHS Trust. She tells Mark about the genetic clues that emerged from the world's largest ever study of 500,000 individuals with chronic back pain across five countries. Producer: Fiona Hill

  • Umbilical cord clamping, Natural cycles, Pedometers
    When is the best time to clamp a baby's umbilical cord? It is a controversial question that has perplexed maternity units for years but new evidence from Nottingham has changed practice at the hospital's busy labour ward. Mark Porter pays them a visit. Natural Cycles is a much promoted contraception app advertised as an alternative to more conventional methods. But the Advertising Standards Authority has ruled that claims of it being 'highly accurate' were misleading so Margaret McCartney expresses her concerns that the app doesn't live up to the hype. And once the initial enthusiasm of having a pedometer wears off do they keep people walking in the long term?