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Inside Health

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Oct 4, 2016 • 28min

Ministrokes, Midwife study, Cyclic vomiting syndrome, Noise in intensive care

Several decades ago, if you had a mini stroke or a transient ischaemic attack, it wasn't unusual for your doctor to tell you to rest in bed with the reassuring words that you'd been lucky. Follow up was casual to say the least, because it was thought that your chances of having a major stroke within the month was negligible. Dr Mark Porter talks to Peter Rothwell, Professor of Clinical Neurology at the University of Oxford, whose research transformed the way mini strokes are treated. TIAs are now seen as medical emergencies requiring urgent treatment. Taking aspirin straight after a TIA, his team's research also showed, could reduce the chance of a major stroke over the next few days by a staggering 80%. Headlines this week from a New Zealand study suggested midwife-led births mean worse outcomes for babies compared with doctor-led care - contradicting other research in the area. Inside Health's Dr Margaret McCartney assesses the new study and concludes the evidence still points to midwife-led care providing reassuringly good outcomes for low risk pregnancies.Imagine being sick for hours, days at a time, recovering for a few weeks, only for the whole cycle to start again as regular as clockwork. Roger McCleery has Cyclic Vomiting Syndrome and every couple of months he's so sick he ends up in hospital, from where he told Mark about the life-changing nature of this unpleasant condition. Consultant paediatric gastroenterologist, Sonny Chong from St Helier Hospital in Surrey who has a special interest in CVS, outlines the possible causes and treatments.Hospitals are getting noisier but in intensive and critical care, 24 hour operations, the noise can be intense, as loud as a busy restaurant with peaks of sound as loud as a pneumatic drill. Researcher Julie Darbyshire, critical care research programme manager at the Kadoorie Centre for Critical Care at the Nuffield Department of Clinical Neurosciences, has been involved in efforts at intensive care units across the Thames Valley to identify excess noise and take steps to muffle it. Peter Edmonds tells Mark how much sleep he missed being in ICU when he was a patient and Matron and Clinical Director at Oxford University Hospitals NHS Foundation Trust, Matt Holdaway, outlines how staff have embraced efforts to cut noise levels.
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Sep 27, 2016 • 28min

Breast cancer, Alcoholism, CRPS, Generics

Breast Cancer and Bisphosphonates; an old drug for treating weak bones can reduce the risk of breast cancer spreading, but many post menopausal women are missing out. Why? Alcoholism and Baclofen; another old drug with a new use, this time a muscle relaxant to help people with an alcohol problem and news of three new trials recently presented in Germany. Complex Regional Pain Syndrome, a rare condition that often occurs after an injury or surgery and results in life changing pain. And why are some generic, non-branded medicines so expensive?
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Sep 20, 2016 • 28min

Welsh patient power, Liquid biopsies, Food allergies, Dosing errors

A new medical movement in Wales is urging patients to take more control of the decisions about the care and treatment they receive. Called Choosing Wisely, it calls for a more equal doctor-patient relationship, an end to "doctor knows best". Dr Paul Myers, chair of the Academy of Medical Royal Colleges in Wales discusses the initiative with Dr Mark Porter and with Inside Health contributor, Dr Margaret McCartney.A new way of tracking cancer, through the blood, not from a biopsy of the tumour, is exciting oncologists worldwide. A liquid biopsy, a simple blood test, is proving to be a hugely promising development in cancer treatment. Circulating tumour DNA is measured in the blood, giving doctors the chance to target new treatments for the particular type of cancer. Dr Mark Porter talks to one of the pioneers in this field, Dr Nick Turner at The Royal Marsden Hospital and team leader at the Institute of Cancer Research about what liquid biopsies could, in the future, mean for cancer care. Traditional advice to parents has been to delay the introduction of foods like peanuts and eggs when they wean their babies onto solid food, in order to reduce the risk of food allergies later in life. But conventional wisdom has been turned on its head with a new body of evidence suggesting the opposite is true. In a new survey of the latest data, the Director of Imperial College's Paediatric Research Unit, Dr Robert Boyle, tells Mark that the two most common childhood food allergies, to peanuts and eggs, may be prevented by introducing them early.How accurate are parents when they're measuring out liquid medicine for their children? Not at all, according to a new study. Dr Margaret McCartney discusses the findings that 84% of the 2,000 or so volunteer parents made at least one error, and 20% made a big error. Scary stuff. But there's advice on how to avoid giving your sick child the wrong dose.
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Sep 13, 2016 • 28min

Obesity and smoking, Blood pressure, ADHD

Is it useful as a public health message to compare obesity and smoking? Controversy in Rome behind a new trial that suggested Blood Pressure targets should get lower. And after a rise of medicating for ADHD over 25 years, the numbers of prescriptions for children has now plateaued. Is this a good news story or is there something more complicated behind the change in trend?
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Sep 2, 2016 • 28min

Why Becomea doctor? 3. A Matter of Life and Death

Kevin Fong explores how doctors cope when things go wrong
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Aug 25, 2016 • 28min

Why Become a Doctor? 2. All Work and No Play?

The real lives of junior doctors today.
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Aug 25, 2016 • 28min

Why Become a Doctor? 1. The Golden Age

Was there ever a golden age in which to train to be a doctor?
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Aug 16, 2016 • 37min

Personalised Medicine: Dose By Design

Vivienne Parry asks if the NHS can deliver the benefits of genomic medicine for all
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Aug 9, 2016 • 28min

Zika in UK, Hip arthroscopy, Limits of cancer treatment

With over 50 confirmed cases of people in the UK with the Zika, Dr Margaret McCartney reviews the latest advice for people worried about the virus. Keyhole surgery for the hip. Dr Mark Porter finds out how hip arthroscopy is increasingly being used to treat problems caused by hip impingement. Sion Glyn Jones, Professor of Orthopaedic Surgery at the University of Oxford and consultant orthopaedic surgeon at the Nuffield Orthopaedic Centre describes which groups appear to benefit most from hip arthroscopy, and Amanda, who had to wait 8 years before keyhole surgery on one of her painful hips, tells Mark about the transformation the operation made to her life. Mark and Margaret discuss the benefits of the "yellow card" system, which allows patients and health professionals to report side effects of drugs.And, as more and more people in the UK are surviving, or living with cancer, thanks to recent advances in treatment, choosing the best approach when faced with a life-limiting disease can be difficult. When cure rates approach 100% for early bowel cancer, advising a patient to have surgery is much easier than recommending aggressive chemotherapy for a hard-to-treat tumour when there's only a slim chance of a cure. Consultant oncologist Sam Guglani, from Cheltenham General Hospital, discusses with Mark the different factors that can influence and impact on the unique relationship between doctor and patient when faced with such choices.
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Aug 2, 2016 • 28min

Statins in the media, Unusual neurological itch, The hunger hormone, Viagra

Has media coverage of statins caused people to come off the drugs? An unusual neurological itch on the arms or back that is often misdiagnosed. Plus Ghrelin, the hormone that makes your tummy rumble and an unexpected surgical side effect that may help in the quest for people to lose weight. And the story of how Viagra was discovered.

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