Inside Health

BBC Radio 4
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Oct 3, 2017 • 28min

Big baby birth trial, Uveitis, Telephone triage, Burns

Mention arthritis and most people think of older people with osteoarthritic hips or knees. But children get arthritis too, although it's an inflammatory condition where the child's immune system attacks the lining of the joints causing pain, swelling and stiffness. But the joints aren't the only part of the body affected. Around one in six of the 12,000 children in the UK with juvenile idiopathic arthritis also develop worrying inflammation in their eyes, uveitis. This is a silent, symptomless condition which can result in significant visual impairment and even blindness. But a new drug treatment, tested in the UK, has proved to be so successful for this group of children that it has revolutionised treatment both in this country and around the world. The benefits were so large that the trial was stopped early and the new therapy adopted as frontline treatment. Dr Mark Porter visits the Bristol Eye Hospital and meets paediatric rheumatology consultant, Professor Athimalaipet Ramanan to find out more.Bigger babies can get stuck in the final stages of labour - a condition called shoulder dystocia. Most are delivered safely but there are both enormous risks to the baby through lack of oxygen and a traumatic experience for the mother. Professor of Obstetrics at Warwick Medical School, Siobhan Quenby, tells Mark that a nationwide trial of big baby births aims to find out whether delivering the child two weeks early, at 38 weeks, reduces shoulder dystocia and makes the birth safer for mother and child.A report by NHS England highlights cost savings of around £100,000 for GP practices that use telephone triage for patients. But the first independent evaluation of this system, where everyone speaks to a doctor on the phone before they get a face to face appointment suggests that policy makers should reconsider their unequivocal support. Inside Health contributor Dr Margaret McCartney, herself a GP, reviews the findings.Several thousand people a year, many of them children, are admitted to hospital every year with serious burns. One of the country's leading centres for burns victims is at the Queen Elizabeth Hospital in Birmingham. As well as serving 13 million people in the local area, the Healing Foundation UK Burns Research Centre treats injured service personnel, airlifted from conflict zones in Iraq and Afghanistan. Mark gets a tour of the unit from director Naiem Moieman and finds out about the newest research on burns treatment which uses some of the oldest remedies.
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Sep 26, 2017 • 28min

Scoliosis, Depression, Pets in Hospital, Eustachian Tubes

After Simon Cowell paid for a Britain's Got talent contestant to have surgery in the US for her curved spine we examine the state of therapy for scoliosis here in the UK. Recent headlines claimed that 1 in 4 teenage girls are depressed but were they accurate? And pets in hospital: the Royal College of Nursing has called for patients to have better access to animals, including their own. Plus Eustachian tubes: tips for what to do if you have blocked ears after your summer holiday.
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Sep 19, 2017 • 28min

Addiction services; Schizophrenia; Hearts and cancer

Inside Health reveals the poor state of addiction services in England with heroin and morphine related deaths the highest on record. Professor Colin Drummond raises concerns about a split in care between the NHS and Local Authorities since the 2012 Health and Social Care Act. And personal testimony is heard from Alison Bedford Russell whose son George died of a heroin overdose last year. The Care Quality Commission, who is responsible for inspections, has found that 2/3 residential drug and alcohol treatment services failed to meet the required standard. Dr Paul Lelliott, Deputy Chief Investigator of hospitals at the CQC, explains what was discovered.The correct use of medical language is a topic close to Inside Health so Margaret McCartney was naturally drawn to discuss news this week about the misuse of the term Schizophrenia.And as London hosts the first ever Cardio-Oncology Summit in Europe, specialists from both fields discuss how to treat and prevent heart problems in people undergoing therapy for cancer.
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Aug 8, 2017 • 28min

Breast density; Health education; Switching outcomes

Breast Density - the major risk factor for breast cancer that you may have never heard of. Health Education - a long term approach to changing attitudes to illness by encouraging children to be less dependent on doctors and pills. Switching Outcomes - one reason why so few clinical trials result in real changes in practice that benefit patients.
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Aug 1, 2017 • 28min

Antibiotics, Lung Cancer, Dying of a Broken Heart, Gender Bias

Margaret McCartney unpicks recent headlines suggesting its okay not to finish your antibiotics; Lung Cancer screening in the high risk; Can you die a broken heart? Evidence suggests this is a real condition called Takotsubo syndrome and is much more common than previously thought. And gender bias in trials.
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Jul 25, 2017 • 28min

PPIs, Aspirin and cancer, Radiotherapy and smoking

There are growing concerns about the widespread use of PPIs, the acid suppressing family of drugs used to treat indigestion and the most prescribed in the world. They are recommended to be used for weeks in typical cases of heartburn, but most people including Mark, take them for months or years. But one reason why PPIs are being used so widely is to protect the lining of the gut from aspirin and combining these two drugs may also have benefits against cancer. Mark hears preliminary findings on the so called chemo-protective effects of aspirin. And radiotherapy is a crucial part of modern cancer treatment so why does it get so little attention compared to drugs? Plus why radiation and smoking are particularly poor bedfellows.
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Jul 18, 2017 • 28min

Hepatitis B vaccine, Sheds, Obesity Paradox, Taking part in clinical trials

The Hepatitis B vaccine has been added to the childhood national programme joining the 5 vaccines already given to all young babies at 8, 12 and 16 weeks. Andrew Pollard, Professor of Paediatric Infection & Immunity at the University of Oxford, and Chair of the Joint Committee on Vaccination and Immunisation, explains why.Margaret McCartney and Mark Porter visit men in north London looking for the physical and mental benefits of community sheds. The obesity paradox - can being overweight sometimes be beneficial? Gavin Murphy, British Heart Foundation Professor of Cardiac Surgery at the University of Leicester and Naveed Sattar, Professor of Metabolic Medicine at the University of Glasgow, debate the latest research suggesting that obese people are more likely to survive heart surgery than their slimmer peers. Are clinical trials good for you? We examine the evidence behind conventional wisdom that people taking part in research tend to fare better - whatever their illness.
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Jul 11, 2017 • 28min

Robo-docs, using AI to diagnose; Pancreatic cancer; Statins and muscle aches

Are we on the cusp of a new era where computers rather than doctors will be doing the diagnosing. Ali Parsa, founder of Babylon Health, believes we are and is developing an online tool using artificial intelligence that diagnoses quicker and more accurately than a doctor. He debates the issues with resident sceptic Dr Margaret McCartney. Mark Porter visits the world's first national tissue bank for pancreatic cancer, set up to aid research into a disease that has seen no outcome improvement for over 40 years. Plus statins and muscle aches; could the drugs' bad press in the media actually increase the odds of people experiencing side effects - the so called nocebo effect?
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Jul 4, 2017 • 28min

High costs of cheap medicines, Can a simple blood test help identify cancer, undescended testes, Aspirin

Price rises of everyday medicines due to some manufacturers utilising monopolies; Can a simple routine blood test help identify cancer; A definitive guide on undescended testes with evidence for the best time to intervene if a baby boy's testes do not drop and the downsides of delay; Aspirin and the risk of stomach bleeds in the elderly.
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Mar 21, 2017 • 28min

Cholesterol-lowering drug, Defibrillators, Post-traumatic stress disorder and heart disease, Lack of drugs in pregnancy

Statins have dominated the cholesterol-lowering field for some years but last week the results of an international trial of Evolocumab, one a new breed of medicines for reducing cholesterol, was hailed as a breakthrough. Professor Peter Sever, one of the leaders of the trial, explains how Evolocumab differs from statins and Dr Margaret McCartney takes a look at the trial.You may have noticed them in work places, gyms, and other public spaces but do you know how and when to use a defibrillator? Every time someone has a cardiac arrest and CPR is performed we should also be running for the nearest defibrillator. But currently this only happens in 2-3% of cardiac arrests, putting thousands of lives at risk every year. Mark speaks to teacher Erica Melsom and the pupil, Alex Cowes, whose life she saved by using the school defibrillator. Professor Gavin Perkins explains why and when we should run and get one. And Mark demonstrates just how simple they are to use, even if you've never touched one before.Posttraumatic Stress Disorder, a psychological condition which can begin after a traumatic event and last for many years, is the equivalent for your cardiovascular system of smoking 10 cigarettes a day. Dr Donald Edmondson explains how extreme stress takes a toll on our arteries.More than 80% of pregnant women take at least one prescribed medication and yet very few of these drugs are actually licensed for use in pregnancy. Mark talks to Professor Anna David about why there has been a reluctance to license medications for use in pregnancy, what impact that has for pregnant women, and what needs to change.Producer: Lorna Stewart.

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