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Sept 5th 2018
Shigella: Everything you need to know about the deadly bacteria
Following the sudden deaths of a British couple at a holiday resort in Egypt last week, two of the guests evacuated from the hotel where the couple were staying have said they have been infected with the bacteria Shigella.
They were among some 300 guests evacuated from the Steigenberger Aqua Magic hotel in Hurghada following the sudden deaths of John and Susan Cooper from Burnley, Lancashire, who died within hours of each other.
Samples tested in a British lab showed that the mother and her young daughter, from the north west, were suffering from infection with the bacteria, which can be transmitted through food or water. It is believed that they caught the infection while staying at the resort. Others are also thought to have been infected.
What is shigella?
Shigella - a group of bacteria similar to E. coli - is a highly contagious and common cause of food poisoning. The bacteria causes the infectious disease known as shigellosis.
There are four different types of shigella. Shigella sonnei and shigella flexneri are the kinds more commonly found in the UK.
Shigella boydii and shigella dysenteriae are more common in developing countries - cases of infection with these types of the bacteria found in the UK tend to be among travellers coming back from holiday. Shigella dysenteriae type 1 can be deadly.
What are the symptoms of shigellosis?</h3>
According to the US Centers for Disease Control and Prevention (CDC), most people who are infected with the bacteria develop diarrhoea, fever, and stomach cramps one to two days after they have been exposed. Mild cases of the infection usually clear up in five to seven days.
Some people who are infected with shigella do not show any symptoms but they are still able to transmit the bacteria to other people.
In more serious cases shigella can cause dysentery - an infection of the intestines that causes bloody or mucus-containing diarrhoea.
How is shigella spread?
Shigella is highly contagious and it takes just a few of the germs to make someone sick. The germs are found in the faeces of infected people while they have diarrhea and for up to two weeks after the diarrhea has gone away.
The germs are spread when someone touches their mouth with hands that have been in contact with the shigella bacteria or eats food with the germ on it.
You can get shigella bacteria on your hands after touching surfaces or objects that have been contaminated with germs from the stool of someone with the infection, eating food made by someone who has shigellosis, handling nappies of an infected child, swallowing infected water or having sexual contact with someone who is infected or is recovering from a recent infection.
How many people catch shigella each year?</h3>
Shigella causes some 165 million cases of disease worldwide each year - mostly among children under five in less wealthy countries.
Countries in sub-Saharan Africa, Central America and Asia have in the past been hit by pandemic waves of the disease.
2,327 laboratory-confirmed cases of shigella infection were reported in England, Wales and Northern Ireland in 2014 compared to 1,991 cases the previous year. At least 20 per cent of cases were related to travel.
Confirmed cases in the UK have risen in recent years - according to Public Health England (PHE) this is most likely due to a rise in infections among gay and bisexual men.
Clusters of cases have in the past also been reported in schools and day care centres - however, there is currently no warning of a general outbreak in the UK.
Is it deadly?
More than one million people are estimated to die from shigella infections each year.
Most cases clear up without issues but serious complications could include severe dehydration, seizures (particularly in children), kidney failure and paralysis of the colon preventing bowel movement or passing gas which could cause the colon to rupture open if left untreated.
Who gets shigella?</h3>
Young children are the most likely to get shigellosis, but anyone can be infected. According to PHE, cases among adults in the UK (not just those returning from holiday) have risen in recent years and the majority of reported cases in the UK are now seen in people over the age of 16.
People who go on holiday to developing countries could contract types of shigellosis that are not easily treated by antibiotics.
There have also been outbreaks of shigella among gay and bisexual men who can transmit the bacteria during sex.
How can you prevent the spread of shigella?
There is still no vaccine to prevent shigella infection so practicing good hygiene is one of the main ways to help prevent the germ from spreading.
According to Mayo Clinic in the US, hygiene measures you can take to prevent the bug from transferring to others include frequent and careful handwashing with soap, not preparing food for other people if you have diarrhoea, keeping children with diarrhoea home from school, cleaning nappy changing areas after use and disposing of dirty nappies in covered, lined bins and not swallowing water from ponds, lakes or untreated pools.
When should you see the doctor?
Severe or persistent cases of shigellosis are usually treated with antibiotics.
You should pay a visit to your GP if symptoms do not improve after a few days or are severe - for example if your or your child's diarrhea is bloody, if the diarrhoea is causing weight loss or dehydration or if it is accompanied by a fever higher than 38 C. Let your doctor know if you have been abroad.
Sept 1st 2018
What is the condition that led Young to step down?
Desert Island Discs fans were crestfallen on Thursday after learning that host Kirsty Young would be stepping down from the beloved BBC Radio 4 programme.
The 49-year-old has presented the show since 2006 and has interviewed some of the most influential names in popular culture, politics and beyond during her tenure, including George Michael, Tom Hanks, Theresa May and Keith Richards
Unfortunately, the esteemed host - whose mellifluous voice has become synonymous with the programme - has had to take “some time away” from the role due to her battle with fibromyalgia.
Young’s inimitable shoes will be filled by Radio 6 DJ Lauren Laverne, 40, while she manages her condition.
What is fibromyalgia?
Fibromyalgia is a long-term condition characterised by chronic pain and tenderness across the body.
While there are some common symptoms, such as fatigue, everyone experiences fibromyalgia differently, with some cases more severe than others.
It’s fairly common, according to the charity Arthritis Research UK, which claims that up to one person in every 25 may be affected.
The symptoms for fibromyalgia can be very similar to inflammatory or degenerative arthritis, however, the conditions are not linked.
There is no specific test for fibromyalgia, meaning it can often be difficult to diagnose.
Who is affected?
Fibromyalgia can affect anyone at any age, though it typically affects roughly seven times as many women as men.
It usually develops between the ages of 30 and 50.
What causes fibromyalgia?
It’s not clear what causes fibromyalgia, but researchers suggests it's related to abnormal amounts of particular chemicals in the brain which disrupt the central nervous system and the way pain is processed in the body.
Others speculate that the condition is genetic.
According to the NHS, in many cases, fibromyalgia is triggered by physically or emotionally stressful events, such as giving birth, having an operation or bereavement.
What are the symptoms?
The most common symptom experienced by people with fibromyalgia is widespread chronic pain, which may be more severe in the back and/or neck.
Other symptoms include fatigue, insomnia, hypersensitivity, spasms, diarrhoea, dizziness and muscle stiffness.
Fibromyalgia can also affect your mental wellbeing, causing something known as “fibro-fog”: problems with memory and concentration.
How is it treated?
There is no known cure for fibromyalgia, however, it can be managed through treatment, which varies depending on your symptoms.
This can be a combination of painkillers, antidepressants, cognitive behavioural therapy and counselling.
Some sufferers may also be advised to embark on specific exercise programmes and relaxation methods in order to help manage and alleviate the pain.
For more information on fibromyalgia, visit Fibromyalgia Action UK, a charity which supports people with the condition.
May 17th 2018
What are the best foods to reduce arthritis symptoms?
Osteoarthritis is the most common of the more than 200 forms of arthritis, affecting more than 20 per cent of the population. Unfortunately, there are currently no effective treatments or approved drugs for this disabling condition, which causes the joints to become painful and stiff. Some new drugs are in the pipeline, but it will be years before they are tested in clinical trials and approved by regulators.
Many people with osteoarthritis take a bewildering variety of dietary supplements, the favourites being glucosamine and chondroitin sulphate, but the evidence doesn’t actually support their use. However, we are happy to report that our recent review of published evidence shows that eating the right foods, combined with moderate low-impact exercise, can benefit people with osteoarthritis.
Firstly, losing weight and exercising are the most significant things that osteoarthritis patients can do to ease their symptoms. Weight loss reduces the load on the joints and lowers the level of inflammation in the body, reducing arthritis pain.
Exercise helps you to lose weight while keeping your muscles strong, which helps protect the joints and makes it easier to move around. So overweight and obese people with osteoarthritis should find ways to lose weight that include exercise aimed at increasing their muscle strength and enhancing their mobility.
Eating certain foods can also help improve patients’ symptoms and reduce their daily joint pain. Evidence shows eating more oily fish such as salmon, mackerel and sardines can improve pain and function in arthritis. This is because the long-chain omega-3 fatty acids they contain reduce the amount of inflammatory substances the body produces. Fish oil supplements of 1.5g per day may also help.
But eating fish oils alone may not be enough. It is also important to reduce the long-term consumption of fatty red meats and replace saturated animal fats with vegetable oils such as olive and rapeseed.
Osteoarthritis patients are more likely to have raised blood cholesterol, so eating in a way that reduces blood cholesterol can help, as well as improving general cardiovascular health. Reducing the amount of saturated fat you eat and increasing the amount of oats and other soluble fibres will help to reduce cholesterol.
Other specific ways to reduce blood cholesterol include eating 30g a day of nuts, 25g a day of soy protein from tofu, soy milk or soy beans, and eating 2g a day of substances called stanols and sterols. These are found in small amounts in plants but the easiest way to consume them is in fortified drinks, spreads, and yogurts that have these substances added to them.
Osteoarthritis occurs when the joints become inflamed by increased amounts of oxygen-containing reactive chemicals in the body. This means that eating more antioxidants, which can neutralise these chemicals, should protect the joints.
Vitamins A, C and E are potent antioxidants you should make sure you get the guideline amounts of them to maintain healthy connective tissues throughout the body. However, the evidence that they improve osteoarthritis symptoms is debatable.
Vitamin A is abundant in carrots, curly kale and sweet potato. Fresh fruits and green vegetables are rich in vitamin C, especially citrus fruits, red and green peppers and blackcurrants. Nuts and seeds are a great dietary source of vitamin E and oils derived from sunflower seeds are rich in vitamin E.
Evidence suggests that increasing the intake of vitamin K sources such as kale, spinach, broccoli and brussels sprouts may also benefit people with osteoarthritis. We also know vitamin D, which your body makes when exposed to sunlight, is important for bone health and many people don’t produce enough.
But more evidence is needed before vitamin D supplements can be recommended for osteoarthritis patients.
Though several popular diet books on arthritis advocate avoiding certain foods, there is no clinical evidence that this benefits osteoarthritis patients.
April 30th 2018
Thousands missing out on safer knee replacements, say experts
Up to 50,000 patients undergoing full knee replacements each year could benefit more from simpler surgery, according to a new study.
Analysis by Oxford University found partial replacements, which are safer and easier to recover from, should be performed on nearly half of those who having full-joint surgery.
Nearly 100,000 knee replacements were carried out in 2016, but fewer than one in 10 patients had a partial replacement, a procedure where only the affected part of the knee joint is replaced.
The procedure is less invasive, allows for a faster recovery, carries less post-operative risks and provides better function.
It is also a cheaper intervention for the NHS, in both the short and long term, they said.
The study saw them analyse data from the National Joint Registry (NJR), where they found that partial replacements are better for patients who have only part of their knee affected by arthritis and could therefore have either a partial or a total replacement.
Related: Fascinating facts about the human body
According to the NJR, of the 98,147 knee replacements undertaken in 2016, only 9 per cent were partial, also known as unicompartmental replacements (UKR).
The research, published in BMJ Open, compared people who had a partial knee replacement with those who had a total knee replacement, but could have had a partial replacement.
They found the use of partial replacement varies greatly between different surgeons.
Partial replacements carried out by surgeons using them for a small proportion of knee replacements provide worse outcomes than total replacements.
But partial replacements carried out by surgeons using them for a high proportion of knee replacements provide better outcomes and are cheaper for the NHS than total replacements, they said.
Co-lead researcher Professor David Murray said: "This is an important finding.
"If surgeons aim to use partial knees in a quarter or more of their knee replacements this will substantially improve the results of knee replacement and will save money.
"In addition more partial knee replacements will be done and more patients will benefit from this procedure."
The team, from the university's Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), said that while partial knee replacements can be better and cheaper for patients over 60, the long-term benefits for those under 60 are less clear compared to those of total knee replacements.
“The main strength of this study is that we were able to use real data, from very large numbers of people, about their actual operations, their GP visit, and their own reported quality of life outcomes in a way that is not always possible,” says co-lead researcher and NDORMS Senior Health Economist Dr Rafael Pinedo-Villanueva.
“This has allowed us to provide strong proof that partial knee replacements are both better for patients and cheaper for the NHS,”
Previous investigations have found as many as one in seven hospital procedures are unnecessary due to a trend of over treatment in the NHS.
The health service has attempted to tackle the problem since Sir Bruce Keogh, its former medical director, attacked “profligate” ordering of unnecessary treatments costing up to £1.8 billion a year, enough to pay the wages of all ambulance staff for three years.
He attributed the problem to low thresholds for interventions, a preference for expensive treatments despite cheaper alternatives being available, and a misdiagnosis of illnesses.
Since then, however, local health chiefs have been increasingly forced to “ration” knee replacements in an effort to cut their costs.
Last year senior officials were forced to intervene after warnings from the Royal College of Surgeons about “alarming” restrictions on surgery when patients were told they would only be referred for NHS procedures if pain left them unable to sleep or carry out daily tasks.
NHS England subsequently issued advice saying such restrictions were banned.
March 30th 2018
‘Arthritis isn’t just for old people’: Six under-30s share the reality of living with the condition
Magician Dynamo, 35, has revealed he’s unable to shuffle cards because of arthritis, a condition that causes pain and inflammation in a person’s joints.
Arthritis is thought to affect a staggering 10 million people in the UK. The two most common types are osteoarthritis, which affects the smooth cartilage lining of a joint, making movement more difficult; and rheumatoid arthritis, which causes pain, swelling and stiffness in the joints. With the latter, symptoms usually affect the hands, feet and wrists.
While it can be all too easy to associate arthritis with older age, the reality is many young people live with the condition too. We asked six people aged 30 and under to share their experiences.
‘Arthritis can be an isolating illness.’
Anoushka Anand, who lives in London, said arthritis can be “very isolating” and as such it’s important to take care of your mental health following a diagnosis. She said her rheumatoid arthritis can cause emotional stress due to “having to deal with daily joint pains whilst being at work, not being able to carry out daily routines and struggling with daily domestic tasks such as cooking, cleaning and struggling to stand in the shower”.
She also said public awareness of the condition needs to improve. Offering an example of where this would help, she explained: “For a young person suffering with arthritis, they may not be at the stage where they are having to use walking aids but when using public transport, they may need to sit down due to pain and stiffness. Like me, they may just suffer in silence and stand; as asking someone who is sitting down, for their seat becomes awkward and embarrassing.”
Feb 12th 2018
A miracle jab that could ease the misery of arthritis for millions of sufferers has been developed by scientists.
The breakthrough may reduce the need for hip and knee replacement surgery that cost the NHS more than £1bn a year.
It is based on a protein that boosts cartilage generation and reduces inflammation of joints.
Experiments on rats and human cells were so successful human trials are now being planned.
A US team said it opens the door to a patient with arthritis forgoing an operation in favour of a shot.
Denis Evseenko, associate professor of orthopaedic surgery, said: "The goal is to make an injectable therapy for an early to moderate level of arthritis."
It offers hope to more than eight million people in the UK with osteoarthritis, the leading cause of joint pain and stiffness.
Until now medications have been designed only to help relieve pain but these have side effects including stomach ulcers, high blood pressure and even stroke.
The new therapy could be a 'game changer' in the treatment of the condition. It also has the potential to treat other painful inflammatory disorders, such as rheumatoid arthritis.
The procedure involves injecting a small molecule into a joint. Prof Evseenko and colleagues discovered it enhances cartilage regeneration while decreasing inflammation.
They are optimistic after "auspicious early results" reported in the Annals of Rheumatic Diseases.
After application to joint cartilage cells in the laboratory, they proliferated more and died less.
And when injected into the knees of rats with damaged cartilage, the animals could more effectively heal their injuries.
Prof Evseenko, of the Keck School of Medicine at the University of Southern California (USC), Los Angeles, said: "It is not going to cure arthritis, but it will delay the progression of arthritis to the damaging stages when patients need joint replacements, which account for a million surgeries a year in the US."
About 160,000 hip and knee replacements a year are carried out by the NHS in England and Wales, with the figure rising by roughly eight per cent annually as the population ages.
As its name implies, the new molecule RCGD 423 (Regulator of Cartilage Growth and Differentiation) fuels regeneration while curbing inflammation.
It exerts its effects by communicating with a specific protein in the body. This molecule, called GP130 (glycoprotein 130) receptor, receives two very different types of signals.
These promote cartilage development in the embryo, and trigger chronic inflammation in the adult.
The study showed RCGD 423 amplifies the Gp130 receptor's ability to receive the developmental signals that can stimulate cartilage regeneration.
At the same time it blocks the inflammatory signals that can lead to cartilage degeneration over the long term.
The team is already laying the groundwork for a clinical trial to test RCGD 423, or a similar molecule, as a treatment for osteoarthritis or juvenile arthritis.
Arthritis is a condition most people associate with the elderly. But it also affects an estimated 15,000 children and young people in the UK.
Natalie Carter, head of research liaison and evaluation at Arthritis Research UK, said: "Although it is still very early days, this injectable treatment could be promising for people with early onset osteoarthritis.
"This piece of research has been conducted in animals, and so it is not yet clear whether this potential therapy could be useful in humans.
"More than eight million people in the UK are living with the pain of osteoarthritis, which can have a devastating impact on everyday life, making such things as getting dressed and getting to work difficult.
"Investment in research that leads to new treatments, such as this, is key to helping these people lead the fulfilled lives they deserve."
Prof Evseenko sees RCGD 423 as a prototype for a new class of anti-inflammatory drugs with a very broad range of uses.
His lab has already developed several structural analogs of RCGD 423 with varying biological effects and potency.
In a previous study published in Nature Cell Biology, RCGD 423 was shown to activate stem cells to make hair grow.
The lab is partnering with other scientists at USC and beyond to explore the broader potential of these molecules.
This includes using them to treat rheumatoid arthritis, jaw arthritis, lupus, neurological and heart diseases and baldness, as well as maintain pluripotent stem cells in the laboratory.
DISCLAIMER: Note that the contents here are not presented from a medical practitioner,and that any and all health care planning should be made under the guidance of your own medical and health practitioners. The content within only presents an overview based upon research for educational purposes and does not replace medical advice from a practicing physician. Further, the information in this manual is provided "as is" and without warranties of any kind either express or implied. Under no circumstances, including, but not limited to, negligence, shall the seller/distributor of this information be liable for any special or consequential damages that result from the use of, or the inability to use, the information presented here. Thank you.
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Arthritis is a big issue. Look at some introductory facts. Referred to as the nation’s number one crippling disease and the most common chronic disease in people over 40, arthritis affects more than 40 million Americans. And this figure is expected to rise to 60 million by 2020, according to the Center for Disease Control.
Arthritis generally afflicts people between the ages of 20 and 50, but can affect all ages, even infants. The average age of onset is 47 and about three out of every five people with arthritis are under 65 years of age.
Arthritic expenditures for just one person due to lost wages, medical treatment and other related expenses can come to more than $150,000 in his or her lifetime.
And doctors believe there are over 100 different forms of arthritis, all sharing one main characteristic: all forms cause joint inflammation.
What can be done for arthritis relief? Many things. For example, weight and nutrition are only a couple of factors that play a role in arthritic pain. And yet shedding even 10 pounds to relieve weight from knees and finding the right nutritional strategy can help relieve pain a lot.
I give you the most recent research and findings available so that you can learn more about arthritis relief, covering as many bases as possible from A to Z. Note that the contents here are not presented from a medical practitioner, and that any and all health care planning should be made under the guidance of your own medical and health practitioners. The content within only presents an overview of arthritis relief research for educational purposes and does not replace medical advice from a professional physician.
Arthritis signals people in a variety of ways. Joints might crack suddenly, like knees upon standing. Other joints may be stiff and creak. Maybe pain occurs, like when trying to open a jar. What’s it all about? Let’s look at the basics and learn more.
Arthritis actually means “joint inflammation” and has over 100 related conditions or type / forms of disease. Left untreated, it can advance, resulting in joint damage that cannot be undone or reversed. So early detection and treatment are important.
The two most common types of arthritis are osteoarthritis (OA) and rheumatoid arthritis (RA). Although both have similar symptoms, both happen for different reasons. When joints are overused and misused, the results can be OA. What happens is that the cushioning cartilage that protects the joint breaks down, resulting in the bones rubbing together. This generally happens in the knees, but can be found in the hips, spine and hands often, too. And only in later stages will a person most often feel pain, after quite a bit of cartilage is lost.
The second type, RA, refers to the body’s immune system attacking joint tissue. Still not fully understood in the medical community, this condition most often starts in a person’s hands, wrists and feet. Then it advances to shoulders, elbows and hips.
Similar symptoms include pain, stiffness, fatigue, weakness, slight fever and inflamed tissue lumps under the skin. And both OA and RA generally develop symmetrically, i.e. affecting the same joints on both the left and right sides of the body.
A difference in OA and RA to note is with swelling. With RA, people report “soft and squishy” swelling. While with OA, people report “hard and bony” swelling.
Another difference is that a person is more likely to develop RA if a sibling or parent had it. While a person with a history of joint damage, either an injury or chronic strain, runs a higher risk for developing OA.
There is no specific age for arthritis sufferers. While it can affect every age group, it seems to focus on those over 45 years of age.
And while neither gender is immune, a reported 74 percent of OA cases (or just over 15 million) occur with women and a slightly lower percentage of RA cases occur with women.
People with excess weight tend to develop OA, especially in the knees when reaching over 45 years of age. However, losing weight can turn the odds around almost by half. Regular activity combined with exercise also reduces risk, strengthening joint muscles and reducing joint wear.
Although there are no cure-alls for arthritis, there are a variety of pain relief treatment strategies. Aside from medications, remedies, replacement alternatives and other helpful treatment options and alternatives, the four main arthritis relief aids are gentle exercise, good nutrition, a positive attitude and rest. And each will be discussed further in subsequent sections, because education can play a huge role to dispel “old wives tales” and myths that “nothing can be done about arthritis.” Notable is that today,
only a small percentage of those afflicted with arthritis become crippled. And most never need canes, wheelchairs, or other ambulatory devices.
Also note if you suspect you may have arthritis, it is advisable to seek
medical advice. Because healthcare providers can help to determine if the
symptoms are not something else like a virus or tendonitis or other similar
problem that could potentially worsen if left untreated.