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Health Care

How simple

Keep the shit and the drinking water separate, and you\’ve gone most of the way from an average life expectancy of 35 to one of 75.

And how true.

More stem cell news

The researchers at Imperial College London are perfecting a technique to rebuild a heart severely damaged and scarred by disease or cardiac arrest.

They have discovered a way to extract, grow in the laboratory and then graft on a patient\’s own muscle-building cells which then can be used to patch up the heart and increase its pumping power.

What amuses me (in a rather ghoulish fashion I admit) is that after all the screams and shouts about embryonic stem cells it appears that all of the treatments we might actually want to use are coming from the use of adult stem cells.

The long life secret?

Given that this is in The Mail I think we might file this under the "immigrants cause cancer to house prices" heading. However, it\’s sourced from the New Scientist which, as long as it doesn\’t stray into matters economic, is a respectable source.

And for centuries it seems we were looking in the wrong place. Forget exotic pills and potions, the key to prolonged life could be as simple as a glass of water. Scientists believe \’heavy water\’ enriched with a rare form of hydrogen could add as much as ten years to life.

And by also modifying foods, such as steak and eggs, with the hydrogen the way could be cleared to allowing us to eat and drink our way to a healthy old age.

The idea is the brainchild of Mikhail Shchepinov, a former Oxford University scientist.

The idea is, as far as I understand it, that deuterium based water protects aginst free radicals rather more than regular dihydrogen monoxide. As to the truth of this I have no idea.

As to the implementation of it, well, there is something of a problem. There\’s a limited amount of deuterium out there. And you have to separate it (and isotopic separation ain\’t one of those simple things to do) from the regular water.

Even if it does work, it ain\’t gonna be cheap.

Fighting the last war

It\’s always said to be generals that do that, but it appears that politicians do too.

At teh moment we\’re all arguing over presumed consent for the use of organs for transplant. Just as the first transgenic organs from pigs are about to hit the market and, just as doctors finally manage to do something useul with adult stem cells.

Surgeons replaced the damaged windpipe of Claudia Castillo, a 30-year-old mother of two, with one created from stem cells grown in a laboratory at Bristol University.

Because the new windpipe was made from cells taken from Ms Castillo\’s own body, using a process called "tissue engineering", she has not needed powerful drugs to prevent her body rejecting the organ.

Avoiding the use of these drugs means she will not be an increased risk of cancer and other diseases unlike other transplant patients – another significant advance.

Five months after the operation was carried out she is now living normally and is able to look after her children again.

Early days yet, they still need a donated organ to create the structure, but guive them a decade or two and there\’s a good possibility that this whole argument over transplnts will simply go away.

Organ donations

A report into organ donation ordered by Gordon Brown will not recommend a system of presumed consent.

There is no possible version of a civilised society in which the default assumption is that your body belongs either to the State or to the society. As Mill pointed out, if you don\’t own your own body you are a slave.

Every year more than 400 people die while waiting for donor organs, mainly kidneys.

And we know how to deal with that, the kidney part at least. Accept that people do own their own bodies and allow them to sell them. This is the system in Iran and no, it isn\’t a coincidence that Iran is the only country in the world without a shortage of kidneys for transplant.

Some things are just too important for us not to enforce property rights and the subsequent markets in the distribution of that property.

Two stories

Story one: remember that rugby player who, at the age of 23, went off to Switzerland to commit suicide because he was a quadriplegic? Just a few weeks ago.

Story two:

Scientists have found a way to regrow damaged optic nerves, raising hopes for people who have been left blind or partially sighted by injuries to the cells.

The technique, developed by a team under Zhigang He at Children\’s hospital in Boston, prompts severed nerves to repair themselves within weeks. The procedure is being tested on spinal cord injuries.

Autism and TV

Or, perhaps, autism and rainfall.

Children who live in areas with heavy rainfall could be more likely to develop autism, scientists claim.

Well, yes. They have indeed found a correlation here. But it\’s rather difficult to take them very seriously. This is a revision of an earlier set of papers which claimed that more TV watching led to autism. The link? They assumed that kids would watch more TV when it was raining, so they measured rainfall and autism and found the correlation.

That earlier study can be viewed here, here.

But now they\’re slightly stuck. They can see the correlation, but can\’t explain causation. No real theory at all.

Owoooooowoooooowoooow!

A father of three who underwent a routine vasectomy at his local GP surgery was left fighting for his life in hospital after suffering gangrene.

Eeek!

It wasn\’t until his stitches burst that he was rushed to hospital and doctors realised how serious his condition was.

Sob, sob, ouch!

 

Assisted Suicide

Joyous:

The 64-year-old Oregon woman, whose lung cancer had been in remission, learned the disease had returned and would likely kill her. Her last hope was a $4,000-a-month drug that her doctor prescribed for her, but the insurance company refused to pay.

What the Oregon Health Plan did agree to cover, however, were drugs for a physician-assisted death. Those drugs would cost about $50.

"It was horrible," Wagner told ABCNews.com. "I got a letter in the mail that basically said if you want to take the pills, we will help you get that from the doctor and we will stand there and watch you die. But we won\’t give you the medication to live."

Interesting, no?

Oh, and by the way, that insurance company? Owned by the State.

 

 

This is a surprise, eh?

Only a tiny fraction of patients unhappy with the NHS make a formal complaint because of a bureaucratic, confusing system which changes little, according to a new report.

Fancy that,

Complaining about the bureaucracy in one of the worldºs largest bureaucracies is bureaucratic.

Ahahahahaha!

The study claims 10 per cent more people are overweight or obese than previously believed, putting them at risk of suffering serious health problems such as diabetes and heart disease.

It says that although they may have a normal Body Mass Index, the calculation usually used to determine obesity, this does not distinguish between lean mass and body fat and so they may still weigh too much.

Yes, we know that the BMI does not distinguish between lean mass and body fat. That\’s actually one of the complaints we have about it. For just about every professional sportsman would be described as (at least) overweight, if not obese, because they, umm, have a lot  of lean mass.

So while it may well be true that there are those who are light but still fat, we can\’t just add 10% to our estimates. We also need to adjust for those who are heavy but not fat….

Tenuous it may be Ben

I\’m not entirely convinced by the argument here, but the actual result seems valid.

Important and timely news from the Journal of Medical Hypotheses this week: ejaculating could be "a potential treatment of nasal congestion in mature males". My reason for bothering you with this will become clear later. The first thing to note is that this is not an entirely ludicrous idea, but it is a tenuous one.

Most decongestant pills work by increasing the activity in the "sympathetic nervous system", which is involved in lots of largely automatic things in the body, such as sweating, blood pressure, and pupil size, as well as the "fight or flight" mechanism. More activitity in the sympathetic system causes the vessels of the nasal mucosa to constrict, reducing their volume, so clearing the blockage.

The argument from Dr Sina Zarrintan runs: "The emission phase of ejaculation is under the control of the sympathetic nervous system … ejaculation will stimulate adrenergic receptors … and stimulation of your adrenergic receptors gives you relief from your cold."

It\’s a chain of reasoning that would make a nutritionist blush….

But what we actually want to know is, does it work? To which I\’m pretty sure the answer is yes.

Now not being a medical type I\’ll get some of this wrong but in general….the sinuses are in one matter rather similar to the tissues of the penis and labia (labiae?)…..during periods of sexual excitement (or if we\’re talking about a married partner, stimulation perhaps) they engorge with blood.

So, if you\’ve got a blocked nose then getting sexually excited should lead to your sinuses engorging, potentially unblocking said nose. So, yes, it does work, but it\’s the excitement not the ejaculation that does it.

It does have to be said though, even if it doesn\’t, who cares? If you\’re snuffling about, feeling sorry for yourself at having caught this damned cold, you\’re going to get cheered up by a bit of medically applied rumpy pumpy anyway, aren\’t you?

Somewhere

The ghost of Linus Pauling is wincing.

Some cancer patients take vitamin C supplements to aid their general wellbeing in the belief it boosts their immune system and helps them fight the disease.

But laboratory studies have found that this may be counter-productive.

Researchers at the prestigious Memorial Sloan-Kettering Cancer Centre in Philadelphia, USA, found that every chemotherapy drug they tested did not work as efficiently if the cancer cells had been pretreated with vitamin C.

In tests, between 30 per cent and 70 per cent fewer cancer cells were killed if they had been treated with vitamin C compared to those not exposed to the vitamin.

Pauling\’s thesis was that large doses of Vitamin C were the cure for cancer.

Prescribing pharmacists

An undercover investigation has found that many pharmacies – especially independent outlets – are relying on poorly-trained staff and failing to give the correct information to customers.

Which?, the consumer watchdog, sent investigators to visit 101 pharmacies across the UK and got unsatisfactory advice on a third of visits, according to an expert panel.

Independent pharmacies fared particularly poorly, giving unsatisfactory advice on around half – 48 per cent – of visits compared to 38 per cent of national and regional chains and 26 per cent of the biggest players and supermarkets.

The outlets failed to give the correct advice to the mystery shopper, who pretended to have traveller\’s diarrhoea in 14 out of the 32 visits. They failed to ask whether the patient had been abroad or for how long they had been suffering.

In many cases the advice was given by a sales assistant who failed to consult the qualified pharmacist, a decision which "astounded" the expert panel.

How odd. The independents, those supposedly owned and run by trained professionals, were worse than those run by money grabbing large corporations.

It\’s also not all that reassuring when you think that the law is being/has been changed so that pharmacists can do more prescribing without reference to a GP.

Targets, targets

Quite the truth of this I\’m not sure:

Road traffic victims who have multiple injuries and fractures are not being transferred to specialist units for surgery fast enough because beds are full of routine cases, orthopaedic surgeons said.

Routine cases such as hip and knee replacements have to be carried out within Government waiting time targets meaning urgent trauma cases are delayed which can jeopardise their recovery.

At their Annual Congress this week, the British Orthopaedic Association heard that patients are being "systematically harmed" as managers try to hit waiting time targets and avoid cancelling operations.

Some patients with pelvic fractures are having surgery delayed by between 10 and 20 days even though this less than half of patients operated on ten days after their injury can expect to make a full recovery.

The resulting more complex surgery and longer rehabilitation is costing the NHS more money than if these trauma patients were operated on quickly, it was argued.

But the basic truth is obvious. If you set targets then people will strive to reach those targets in the easiest manner possible. And that easiest manner possible might not be quite what you actually want.

We see even the Guardianistas waking up to the principal agent problem when traders get bonuses for short term successs at the risk of long term blow up. It\’s not all that different here. Set a target and the health system will attempt to achieve it, but that may not be actually what you want…like people being dragged in from car crashes and not getting the treatment they need….and the treatment that of course we all desire they get.

Which leads on to an interesting and more subtle point. What is it that we actually want from a "national health service"? Is it health insurance? Or health assurance?

We know that we can\’t have the latter in totality. We all agree that most of us have to make some direct contribution, through prescription charges, paying for our own glasses, that sort of thing.

But health insurance is different, this is something that can be provided collectively and through the State. If some medical calamity befalls you, like said car smash, or a vile cancer, some chronic disability, then the NHS can and arguably should treat you at no direct cost.

Assurance here meaning, aswith life assurance, payment for something that will definitely happen. We\’ll all need some health care at some point. Insurance, again as with other insurances, is protection against those calamities which will happen to some percentage of us but not all. And the costs of it happening are simply not possible to cover directly (think fire insurance for a house) thus we pool the risks.

But if the NHS is not covering us for those insurable risks, and it cannot be a full system of assurance, then are we sure that we\’ve got the system we want?

Leave aside all the stuff about internal and external markets, methods of funding and so on, isn\’t it an insurance scheme that we want, first and foremost? And if it isn\’t that, then is it fit for function at all?

NHS efficiency

Doesn\’t look good, does it?

Official figures compiled by the Office for National Statistics show that the amount of treatment the NHS delivers is lagging behind the pace of increase in the service\’s budget.

Critics said the statistics showed the NHS had absorbed huge amounts of money with very little to show for it and the Government must reform its management instead of pumping in ever more funding.

NHS productivity fell by 2.0 per cent a year between 2001 and 2005, according to the Centre for the Measurement of Government Activity, the ONS unit that monitors public spending. That was the period of the biggest funding increase in NHS history.

And the defence is?

all NHS staff have enjoyed well deserved pay rises.

Well, yes, rather the point that\’s being made. We\’re now paying people more than we used to to do the same thing. So productivity, measured as the amount of money we spend for a specific output, has fallen.

That\’s not so much a defence or an explanation as a confirmation.

 

Squeal Again!

WHO is the mandated leader in global health. It is time to enhance WHO’s leadership role through the agenda for action on the social determinants of health and global health equity.

A report from WHO says that WHO is very important, oh yes indeed.

Bit of a surprise to see that in there, isn\’t it?

They\’re insane

Global governance mechanisms – such as the Framework Convention on Tobacco Control – are required with increasing urgency as market integration expands and accelerates circulation of and access to health-damaging commodities. Processed foods and alcohol are two prime candidates for stronger global, regional, and national regulatory controls.

Global prohibition of alcohol and trans fats. In the name of equity, of course.

Yet more!

Health is not a tradable commodity. It is a matter of rights and a public sector duty. As such, resources for health must be equitable and universal. There are three linked issues. First, experience shows that commercialization of vital social goods such as education and health care produces health inequity. Provision of such vital social goods must be governed by the public sector, rather than being left to markets.

Yup, we\’ve got to abolish the private school system globally in order to ensure health equity.