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Inside Health

Latest episodes

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Sep 8, 2015 • 28min

Aspirin and heart attacks, BPPV vertigo, Patronising language, Carpal tunnel sydrome, Osteoporosis treatment

Dr Mark Porter presents a programme devoted to questions from the listeners.Dr Mike Knapton from the British Heart Foundation answers a question about whether aspirin can protect against a second heart attack.A number of people asked about the treatment of vertigo. Vertigo is a symptom of a variety of conditions ranging from migraine and Meniere's, to strokes and tumours, but by far the most common is a condition called BPPV - benign paroxysmal positional vertigo. It is caused by debris floating around in the fluid in the balance sensors of the inner ear and typically affects people over 40. And there is a relatively simple way to treat it called the Epley movement, which is much underused. Dr Louisa Murdin, consultant in vestibular and balance disorders at Guy's and St Thomas's hospitals in London, explained how she uses the technique.Dr Margaret McCartney and Mark discuss why doctors sometimes use patronising language when talking to patients.Carpal tunnel syndrome - which normally eventually affects both hands - is caused by pressure on the median nerve as it passes under the flexor retinaculum ligament at the wrist - close to where the clasp or buckle on your watch would sit. The classic story is pins and needles affecting the thumb side of the hand and sparing the little finger, and often worse during the early hours of the morning.Dr Jeremy Bland, consultant in clinical neurophysiology at King's College Hospital London, and Kent and Canterbury Hospital, where he runs one of the few NHS clinics dedicated solely to carpal tunnel syndrome, explains why people wake up with symptoms and why wearing a splint can be helpful.Osteoporosis features regularly in our in-box - particularly concerns about bisphosphonates, the gold standard treatment for the bone thinning condition. Every year in the UK around 300,000 people break a bone - such as a hip or wrist - following a relatively trivial injury because their bones are weaker than they should be. Most are middle aged and elderly.Drugs like alendronate and etidronate are prescribed to make bones stronger after a fracture. Peter Selby, Professor of metabolic bone disease at the University of Manchester and a consultant at the Manchester Royal Infirmary, answers queries about how long these drugs should be taken.
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Sep 1, 2015 • 28min

Meningitis B, Hormones and depression, Statins, Unexpected heart attacks

From this week all UK babies will be vaccinated against that most feared disease, meningitis B, the first country in the world to take this step. But the decision to include Men B in the national immunisation programme has come too late for parents, Freya and Ross. A year ago their baby daughter, Harmonie, nearly died after contracting the infection. Her arms and legs as well as the tip of her nose had to be amputated because of the resulting sepsis. Sue Davie, Chief Executive of Meningitis Now tells Mark that the vaccine is great news and will save many lives. But she hopes in the future that it will be offered to older babies and young children, as well as another at risk group, adolescents. Mental health problems have long been linked to fluctuating hormone levels, at times of menstruation, childbirth and menopause. Dr Michael Craig who runs the Female Hormone Clinic at the Maudsley Hospital in London discusses the role of hormone replacement treatments.Statins are the most commonly prescribed medicines in the UK. They work to lower the level of cholesterol in your blood. There's been considerable debate about when doctors should start prescribing statins and NICE, the National Institute for Health and Care Excellence, had been keen for GPs to be paid to put more patients on the cholesterol-reducing drugs. Dr Margaret McCartney outlines the controversy and NICE Deputy Chief Executive, Professor Gillian Leng, tells Mark that the health advisory body has listened to concerns and why their new statins targets are now to be tested in the field.Young, healthy, sporty people don't get heart attacks. Except when they do. Dr Stuart Miller, Clinical Director of Sport and Exercise Medicine at the University of Bath admits that he was shocked when he had a heart attack, even though he cycles, swims and eats a healthy diet. Sanjay Sharma is professor of cardiology at St George's Hospital in London and he tells Mark how common unexpected heart attacks are. Producer: Fiona Hill.
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Aug 13, 2015 • 28min

Emergency abdominal surgery, Thermometers, Vitamins and dementia, Risk

Why more than 1 in 10 people having emergency abdominal surgery die within 30 days of their operation. Which thermometers parents should use and which they should not. Vitamins and dementia - a controversy dividing scientists. Could taking B vitamins lower the levels of the amino acid homocysteine and slow the onset of Alzheimer's disease? Absolute risk v relative risk.
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Jul 28, 2015 • 28min

Off-patent Drugs Bill, Pre-diabetes, Sepsis, All-cause mortality

The Off-Patent Drugs Bill aims to prevent people missing out on life-saving treatments, but doctors can already prescribe drugs off-licence so why do we need a new law? Pre-diabetes - a new label that could apply to as many as 1 in 3 British adults, but is it a useful to know this? The importance of diagnosing sepsis early and how to recognise the key signs. Plus Dr Margaret McCartney and Dr Carl Heneghan explain the meaning of the phrase 'all cause mortality'. Presented by Dr Mark Porter.
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Jul 21, 2015 • 28min

Asthma inhalers, Knee arthroscopy, Pelvic girdle pain, Medically unexplained symptoms

Elite athletes are far more likely to use asthma inhalers than the general population. Do the stresses and strains of competition bring on asthma-type symptoms or does an inhaler give a performance advantage to individual sportsmen and women? Dr Mark Porter talks to sports physician Dr Babette Pluim about her review of the use of inhalers in sport.One hundred and fifty thousand knee arthroscopies are performed every year in the NHS with most of them involving surgery to smooth, remove or repair damaged cartilage, the meniscus. But there are concerns that we do too many arthroscopies in the light of evidence that intervention isn't always required. Andrew Price, Professor of Orthopaedic Surgery at the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences at the University of Oxford, tells Mark when surgery is useful and Inside Health's Dr Margaret McCartney reviews the mounting body of evidence that has called into question some knee surgery. Dr Annabel Bentley, former Medical Director of Insurance at the private health insurers, BUPA, describes how, back in 2011, there was an instant (and subsequently sustained) reduction of 9% in knee arthroscopy claims. The drop came weeks before a new checking process, to confirm the surgery was in line with best practice, was introduced.Pelvic Girdle Pain is a condition that affects one in five pregnant women. It causes discomfort in the pubic region, the hips and lower back and gets worse as the pregnancy progresses. Some cases can be mild but more severe forms can leave a woman needing crutches, or even a wheelchair, to get around. But there is help out there and official advice is for women to get help early and not to suffer in silence. Mark visits the Rosie Maternity Hospital in Cambridge, and speaks to new mum Joanna Welham and Women's and Men's Health Physiotherapist, Claire Brown, about what treatment is available.Medically unexplained symptoms, sometimes known as MUS, cause problems for both patient and doctor, and they're common, up to a fifth of a GP's workload, and around half of all specialist referrals, costing the NHS more than £3 billion a year. Rona Moss Morris is Professor of Psychology as Applied to Medicine at King's College London and she believes the NHS fails such patients. She tells Mark what she thinks needs to change, starting with the name, MUS.Producer: Fiona Hill.
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Jul 14, 2015 • 28min

Tax on sugary drinks, Low libido in women, Europe's largest robotic pharmacy

What is the evidence that taxing sugary drinks will help to tackle obesity? Low libido in women - what is Hypoactive Sexual Desire Disorder and where did the diagnosis originally come from? Is it a label that will liberate millions of women or a construct to market new drugs? Plus Mark visits Europe's largest robotic pharmacy at a brand new hospital in Bristol.
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Jul 7, 2015 • 28min

Gestational diabetes, Low-carb diets, Needle pain

Diabetes in pregnancy, gestational diabetes, is on the increase, and the risks to mother and baby if this condition is untreated, are very serious. Around one in fourteen pregnant women will develop GD, but the risk is much greater according to age and weight of the mother, whether there's a history of diabetes in the family and in certain ethnic groups. Dr Mark Porter visits The Rosie Maternity Hospital in Cambridge, where Dr Helen Murphy introduces him to the specialist teams that enable 70% of the women diagnosed there to manage their diabetes through diet and exercise, rather than medication. The UK's National Institute for Health and Care Excellence, NICE, has introduced new guidelines for diagnosing gestational diabetes which differ from international thresholds backed by the World Health Organisation. Mark talks to researcher Dr Claire Meek from The Rosie, one of the authors of research published in the journal Diabetologia, which found that up to 4,000 women, at risk of serious birth complications, would be missed under the new UK criteria. The teams at The Rosie are shunning the new NICE guidelines and continuing to follow the WHO thresholds. Professor Rudy Bilous, who runs the Diabetes in Pregnancy Service at the James Cook University Hospital in Middlesbrough and chaired the development group at NICE that produced the new diagnostic guidelines, tells Mark that he's confident that the thresholds, which were drawn up using the latest available evidence, are set at the right level. Weight loss properties and low carbohydrate diets: listener Mark Robins from Southampton describes his success following a low carb diet (he lost nearly four stone in a year) and Inside Health's Dr Margaret McCartney and Susan Jebb, Professor of Diet and Population Health at the University of Oxford discuss the evidence behind weight loss and low carb diets.The number of children who say they are afraid of injections is increasing and Dr Amy Baxter, a paediatric emergency doctor from Atlanta, Georgia and an expert in needle pain, has shown a link between the number of jabs and fear of needles. UK children have up to 15 vaccinations, with the new Meningitis B on the horizon, so managing that fear is important. Dr Baxter tells Mark what parents and health care professionals can do to help, and saying "Sit still, don't move, this will only hurt a bit", isn't recommended!Producer: Fiona Hill.
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Jun 23, 2015 • 28min

Future of 7-day GP Access Pilots, Mers, Laughing Gas Health Risks

Across England, selected GP surgeries are trialling 7-day working, but there are reports that take-up has been so low in some areas, particularly on Sundays, that pilots have been abandoned. Dr Margaret McCartney and Dr Mark Porter investigate where the pressure for extended opening hours is coming from. Mark visits Herefordshire where Taurus Healthcare, a federation of local GPs, is running a late night/weekend service. Managing Director Graeme Cleland describes the high take-up of the service after an initial slow start, and says new patients have been treated, showing previously latent demand in the system. Mike Dando is a wheelchair user with spina bifida and diabetes, and before the pilot started a year ago, he would have to wait in all day for a district nurse to dress his ulcerated legs. Now he just makes an appointment at a time convenient for him. But at the end of this year the seed money provided by the Prime Minister's Challenge Fund runs out, so what will happen to the Herefordshire pilot? Chair of the local Clinical Commissioning Group, Dr Andy Watts, says without extra funding, the pilot service is unlikely to continue and deputy chair of the BMA's GP Committee, Dr Richard Vautrey, calls for investment in current GP practices rather than expensive additional services.Doctors in the UK have been warned by public health officials to be on the lookout for people who become ill after travelling to South Korea. Middle East Respiratory Syndrome (MERS) has killed 27 people in the region and there are 174 confirmed cases of the disease. Nearly five hundred people have died worldwide after the virus first emerged three years ago, in Saudia Arabia. Jonathan Ball, Professor of Molecular Virology at the University of Nottingham, describes how coronaviruses like MERS (and SARS) jump to humans via an intermediary animal. In the case of MERS, that's via the Dromedary camel.Nitrous Oxide or laughing gas has a long history of recreational use but in recent years, there's been an exponential growth in use among teenagers and young people. Founder of the Psychedelic Society, Stephen Reid, describes the physical effects of laughing gas and tells Mark why he believes the gas shouldn't form part of the government's planned clampdown on legal highs. But Dr Paul Seddon, respiratory paediatrician from Queen Alexandra Children's Hospital in Brighton, warns that increased use could mean increased health problems, like the case of the teenager girl with a collapsed lung admitted to his hospital after inhaling the gas.Producer: Fiona Hill.
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Jun 16, 2015 • 28min

Cervical Screening in Older Women; Hepatitis E in Nepal; Enlarged Prostate; Significance

Cervical screening in older women has hit the headlines, but reports have not explained whether these women being diagnosed after 65 have attended screening. Concerns about an outbreak of Hepatitis E in Nepal that could kill pregnant women; A new technique being trialled in the UK to treat enlarged prostate; and Dr Margaret McCartney on statistical significance.
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Jun 10, 2015 • 28min

Flibanserin; Strokes in young people; Outdoor swimming; Research terminology - Causation v Association

Treating low sex drive in women. Expert panels in the USA have voted in favour of a drug that has been dubbed 'Pink Viagra', but there are serious reservations. Outdoor swimming is the new trend for 2015, but should you take the plunge or go in slowly? Strokes in the under 55's have recently been reported to be on the increase: Dr Margaret McCartney takes a closer look at the evidence. And unpicking tricky terms to understand your health - causation versus association. Presented by Dr Mark Porter.

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