Inside Health

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.

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.

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.

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.

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.

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.

In the last of the current series Mark Porter answers your feedback on sex education, off licence use of drugs and drinking smoothies instead of eating fruit.Plus hospital bed numbers have been halved over 25 years, while admissions have rocketed - up by 3 million in the last decade alone; Inside Health discusses how hospitals have been coping.Plus calls for frailty to be an official diagnosis rather than simply a general description - Mark Porter examines the implications.

Mark Porter visits a very smelly laboratory to find out how your gut bacteria could be influencing your weight - and more besides.Doctors have written to the authorities asking for permission to use the drug Avastin instead of the more expensive alternative, Lucentis, to treat patients with age related macular degeneration (AMD) - the commonest cause of blindness in older people. Inside Health investigates.And new research into peanut allergy, turning conventional wisdom on its head, that every parent should know.

The big news in public health this week with the parliamentary vote on the introduction of standardised cigarette packets. A move the tobacco industry has resisted fiercely. Inside Health discusses the evidence for the sort of impact the policy might have on the nation's smoking habits?The difficult issue of when and how to tell children about sex. Schools throughout England are to be offered new guidance to help them with sex education in PHSE classes for KS3 and KS4 pupils. But, the classes are still not going to be made a statutory part of the curriculum. Inside Health's Margaret McCartney examines the evidence.And a listener has asked about gallstones after a recent scan had shown debris or sludge in the gallbladder.Plus news from Las Vegas, New York and the UK on trends in plastic surgery.

Recent research was widely reported as concluding that 30 year old guidance to limit saturated fats had been overturned and should never have been introduced - and that we can now eat as much butter, cheese, sausages and pies as we like.But, as ever, the real story is a bit different. Inside Health debates the real evidence and hears from Sweden that rumours of change in its guidance have also been misreported.As big companies try to attract female employees by offering 'egg freezing' as a corporate carrot, Dr Mark Porter examines the success rates and implications for women wanting to start a family.And checking your moles - how to tell the difference between the sinister and the innocent.