Prescriptions for nerve drugs pregabalin and gabapentin have risen dramatically in recent years and at the same time, concerns about abuse. Former prisoner and addict "Patrick" tells Dr Mark Porter that "gabbies" or "pregabs" are drugs of choice in jail and Dr Iain Brew, a GP who works in prisons, says misuse is a growing problem and there are examples of doctors being pressurised into prescribing them. Dr Cathy Stannard, consultant in pain medicine at Southmead Hospital in Bristol, chaired an expert group that drew up new prescribing guidelines for pregabalin and gabapentin and she tells Mark that more attention needs to be paid to emerging evidence of misuse. Many women say that if they've had one caesarean section, they feel pressurised to have another one and Sara describes how her medical team planted "a seed of doubt" about the potential risks to her baby which she says for her meant another C-Section was inevitable. But new guidelines from the Royal College of Obstetricians and Gynaecologists spell out that vaginal birth after a previous caesarean is a clinically safe choice, with a 75% success rate, the same as for first-time mothers. Inside Health's Dr Margaret McCartney discusses the history of changing attitudes to natural birth after caesarean and says why the new guidelines should give future mothers the confidence to discuss, well in advance of their birth, the best option for them. How do you fill in health check forms that ask for family history if you don't know who your family was? Inside Health listener Jessica is adopted and her heart health check suggested a very low risk of a stroke or heart attack when she couldn't answer the family history question. Mark and Margaret discuss how common this is, and what difference family knowledge would make to Jessica's risk (not much).Adrenaline auto injectors were first used in the 1960s when they were developed for soldiers to use during nerve gas attacks allowing them to self administer the antidote. But is a device designed to be used by fit, trained soldiers just as suitable for use in children and adults of widely varying size and weight? These concerns were raised by a coroner conducting the inquest into the death of a 19 year old student who died of anaphylactic shock caused by a nut allergy, despite her using her auto injector. The Medicine and Healthcare Products Regulatory Authority and also the European Medicines Agency have been looking into issue and Dr Robert Boyle, allergy specialist at St Mary's Hospital, Paddington and Director of the Paediatric Research Unit at Imperial College, London provided expert advice. He talks to Mark about the limitations of auto injector design and urges everybody who might use the devices to ensure they are confident about exactly how to use them.
Gesundheit, Wellness & Beauty
Inside Health Folgen
Series that demystifies health issues, separating fact from fiction and bringing clarity to conflicting health advice.
Folgen von Inside Health
381 Folgen
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Folge vom 06.10.2015Pregabalin and gabapentin misuse, Natural birth after caesarean, Adrenaline auto-injectors
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Folge vom 29.09.2015Pollution, Falls in the elderly, False positives and negatives, Meningitis B and teenagersAs cars were banned from central Paris this weekend and the health risks of pollution hit the headlines, Mark Porter examines the statistic that pollution kills 29,000 people a year in the UK.And he visits a pioneering clinic at Southampton General Hospital where falls in the elderly are seen as a risk factor for underlying health problems; 'Having a hip fracture is like having a heart attack or stroke' explains Dr Mark Baxter. 50% of people who have a hip fracture will have previously presented with a fall, but once they go on to break a hip, 1 in 10 elderly people may not be alive at the end of the month and up to 25% by the end of the year. Many elderly people are found to be on multiple treatments - blood pressure pills or bladder pills for example - that make people fall over. In recent years there has been much more attention paid to the cumulative burden of the side effects of medicines in the elderly - particularly the group of commonly used drugs known as Anticholinergics. And according to new research by a team at the University of East Anglia, taking Anticholinergics increases the risk of falls too - particularly in men.Following news of the Meningitis B vaccine in children, an Inside Health listener got in touch to ask why it wasn't being given to teenagers in light of data showing that there is a second peak in incidence in the disease among 15 - 19 year olds? Mark talks to Professor Andrew Pollard, Chair of the Joint Committee on Vaccination and Immunisation.And Inside Language: Dr Margaret McCartney and Professor Carl Heneghan demystify the terminology of medicine and research. This week, false positives and false negatives; when is something not what it seems, and when does it seem what it's not?
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Folge vom 22.09.2015Cancer drugs fund, Winter flu vaccine, Bandy legs and knock knees, Peer reviewFor five years the Cancer Drugs Fund has supplied seventy five thousand patients in England with cancer drugs, but its days are numbered. Spiralling costs have led to a reduction in the number of drugs the CDF will pay for, meaning newly-diagnosed patients may miss out. Dr Mark Porter talks to Vicky Rockingham about the anxiety that reform of the CDF is causing. Vicky is a mother of two, working full time, and receiving regorafenib paid for by the CDF for her rare type of gastrointestinal stromal tumour, or GIST. She tells Mark that the drugs from the CDF are giving her extra time with her family and enabling her to carry on working. And Jonathan Pearce, Chair of Cancer 52, an alliance of organisations that represent people with less common and rarer cancers like Vicky's, tells Mark why any new-model CDF must take into account individual patient needs. Regular Inside Health contributor, Dr Margaret McCartney, describes how patients access cancer drugs in Scotland, Wales and Northern Ireland and discusses with Mark the difficult decisions that access to expensive and innovative new cancer medicines present for the NHS.Last season's winter flu vaccine provided only limited protection to those who received it. An exceptional year where there was a mismatch between the flu virus that eventually circulated, and the vaccine that had been developed by international teams. The result was just 30% protection (down from its usual 70-80%). Dr Mark Porter asks the chair of the Joint Committee on Vaccination and Immunisation (JCVI), Professor Andrew Pollard, whether confidence in this year's vaccine could be dented.Babies, toddlers and pre-school children often seem to have bow legs and knock-knees and parents frequently turn up at their doctor's surgery asking for reassurance about the way their children walk. Manoj Ramachandran, consultant children's orthopaedic and trauma surgeon based at The Royal London and Bart's Hospital tells Mark that up to a quarter of the children referred to his clinics have normal, developmental lower limb variants. Children are naturally bow legged when they first walk and by the age of three, there's another natural re-alignment which tends to lead to knock knees. At both these ages his clinic receives a peak in referrals but by the age of seven, he says, most childrens' legs straighten up naturally.Inside Language: Carl Heneghan, Professor of Evidence Based Medicine at the University of Oxford and Dr Margaret McCartney continue to demystify the scientific language of medicine. This week, peer review.Producer: Fiona Hill.
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Folge vom 15.09.2015League tables, Nits, Feeling the cold, Language - Surrogate markerAre league tables listing surgical outcomes the best way to assess your surgeon or are high risk patients being turned away as surgeons keep an eye on their figures? New data published this week list the clinical outcomes for heart surgery - cardiac surgeons are just one speciality from an ever expanding list of doctors whose performance is now published in league tables and subject to public scrutiny. But what impact has their introduction had on patient care? Sam Nashef, a consultant cardiac surgeon at Papworth Hopsital, discusses this issue with Mark Porter.Recent research in schools in Wales suggest that as many as one in 12 primary school children get them at this time of year - and that compares favourably with Australian research, which suggests the figure's much higher - closer to one in five. Resident sceptic Dr Margaret McCartney explains which treatments are supported by evidence.Lyn e-mailed Inside Health to understand why she often feels colder than other people. How, she asked, do we regulate our body temperature and are some people better at it than others? George Havenith is Professor of Environmental Physiology and Ergonomics at Loughborough University, and Mike Tipton, Professor of Human and Applied Physiology at the University of Portsmouth, provide answers.And in the next of our special series demystifying the language of research and statistics Carl Heneghan, Professor of Evidence Based Medicine at the University of Oxford and Dr Margaret McCartney unpack the concept of surrogate markers. These feature increasingly in medical research and can involve everything from blood test results, to the pattern on your heart trace or ECG.