Viagra helps ailing hearts to recover in a surprising way – by making them less stiff and allowing them to pump more efficiently scientists have learned.The impotency drug causes too-rigid heart chamber walls to become more elastic. The research explains how Viagra might benefit patients with diastolic heart failure.

People with the condition have abnormally inflexible ventricles, the heart’s major pumping chambers, that do not fill sufficiently with blood.

This leads to blood ”backing up” in the lungs and breathing difficulties.

Scientists found that Viagra activates an enzyme that causes a protein in heart muscle cells to relax.

The effect was seen in dogs with diastolic heart failure within minutes of the drug being administered.

Study leader Professor Wolfgang Linke, from the Ruhr Universitat Bochum (RUB) in Germany, said: ”We have developed a therapy in an animal model that, for the first time, also raises hopes for the successful treatment of patients.”

Viagra has a similar effect on blood vessels, which is why it was originally developed as a treatment for high blood pressure and heart disease.

The drug’s active ingredient, sildenafil, inhibits an enzyme involved in the mechanism that regulates blood flow.  However, the enzyme is slightly different in different parts of the body.

The British scientists behind Viagra found to their initial disappointment that it was not a great help to patients with high blood pressure. But it had a miraculous effect on men with erectile dysfunctin.

The drug successfully suppressed the enzyme phosphodiesterase (PDE) in the penis, increasing blood flow to the organ.

Prof Linke’s team found that it worked on the same enzyme in heart cells. This had the effect of causing a cardiac muscle protein called titin to become more elastic.

”The titin molecules are similar to rubber bands,” said the professor. ”They contribute decisively to the stiffness of cardiac walls.”

The research was initially published in the journal Circulation of the American Heart Association.

Almost half of emergency patients admitted to hospital with heart failure have a diastolic condition.

Various medical conditions can cause the ventricles to become ”stiff”. They include high blood pressure, blocked arteries, and cardiomyopathy heart disorders.

Sildenafil is already being tested on heart failure patients taking part in the Relax trial in the US.

Two senior paediatric pathologists say they have discovered vitamin D deficiency in a significant number of children who have died of Sudden Infant Death Syndrome (SIDS)- cot deaths.The two doctors, Dr Irene Scheimberg and Dr Marta Cohen, say that vitamin D deficiency and associated diseases such as the bone disease rickets could also explain deaths that are often thought to be suspicious.

Both doctors believe their findings merit further investigation and research.

The findings in children from London and Yorkshire followed the discovery by Dr Scheimberg in 2009 of congenital rickets in a four-month-old baby whose parents had been accused of shaking him to death.

Chana Al-Alas,19, and Rohan Wray, 22, were acquitted of murdering their son Jayden after the jury learned that his fractures, supposedly tell tale signs of abuse, could have been caused by his severe rickets. Dr Scheimberg also discovered rickets in Jayden’s mother.

In London, Dr Scheimberg discovered vitamin D deficiency in a further 30 cases. Vitamin D deficiency was found to be a cause of death in three cases. Cardiomyopathy, a disease of the heart muscle, was discovered in two small babies. A third died of hypocalcemic fits, a condition of low serum calcium levels in the blood caused by vitamin D deficiency.

Vitamin D deficiency was a co-existing finding in the sudden and unexpected deaths of eight children, so-called Sudden Infant Death or Sids; in five children with bronchial asthma and another five with combined bacteria-polyviral or polyviral infections. Two of the babies, including baby Jayden, also had rib fractures.

In Yorkshire, Dr Cohen found moderate to severe levels of vitamin D deficiency in 45 children, mostly infants aged less than 12 months, who died of natural causes. Of the 24 sudden infant deaths Dr Cohen investigated from this group, 18 – or 75% – were deficient in vitamin D.

Dr Scheimberg said severe vitamin D deficiency could make the bones of small babies very brittle and capable of fracture with little or no real force.

Dame Sally Davies Chief Medical Officer was quoted as “We need to investigate the vitamin D levels of these children carefully and the circumstances in which the bones fracture,” she explained.

“Obviously if you have bones that fracture easily then they will fracture easily they will fracture with any normal movement like trying to put a baby grow on a baby you will twist their arm. In a normal child you won’t produce anything. But in a child whose bones are weakened and [who have] an abnormal cartilage growth area, then it’s easier for them to get these very tiny fractures or even big fractures.”

Vitamin D is actually a hormone, and endocrinologists are experts in how the body is regulated by the hormone excreting glands – or endocrine organs.

Stephen Nussey is professor of endocrinology at St George’s Hospital at Tooting in south London. He believes that, despite repeated government recommendations on vitamin D supplementation, vitamin D deficiency is still not being taken sufficiently seriously by the authorities.

“Lizards are quite like humans in their vitamin D. Their dietary intake is pretty low and they need to have sun exposure and you need to have a light in the enclosure in which you keep your lizard of the right wavelength.

“If you don’t have one of those lights your reptile will get osteomalacia [adult rickets] very similar to humans. I guess the RSPCA would quite rightly prosecute you if you didn’t give your reptile vitamin D.

“But there’s no action taken against you if you don’t give it to your daughter. So that rather illustrates the importance placed on vitamin D for your reptile rather than giving it to your daughter.”

Earlier this week, the chief medical officer for England, Dame Sally Davies, wrote to doctors, nurses and other health professionals advising them to consider vitamin D supplementation for certain at risk groups, including pregnant mothers.

“We know a significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood. People at risk of vitamin D deficiency, including pregnant women and children under five, are already advised to take daily supplements. Our experts are clear – low levels of vitamin D can increase the risk of poor bone health, including rickets in young children,” she explained.

“Many health professionals such as midwives, GPs and nurses give advice on supplements and it is crucial they continue to offer this advice as part of routine consultations and ensure disadvantaged families have access to free vitamin supplements through our Healthy Start scheme.

“It is important to raise awareness of this issue, and I will be contacting health professionals on the need to prescribe and recommend vitamin D supplements to at risk groups.

From: http://multi-vitamins.eu/vitamin-d-deficiencies-linked-to-cot-deaths-sids

Penicillin doses for children need to be reviewed to take account of the fact youngsters are getting heavier meaning they may not be getting an adequate dose doctors have said.Dosing guidelines have remained unchanged for almost 50 years and are mostly based on children’s ages.

But experts argue that the dose a child needs is determined by their weight – and the average weight of children has increased.

It means that children may not be receiving a big enough dose of antibiotics to combat their infection.

Giving inadequate doses also encourages bacteria to become resistant to antibiotics making them harder to treat in future, it was warned.

The average weight today of a five-year-old is 21kg and a 37kg for a 10-year-old – up to 20% higher than in 1963, researchers at King’s College London sad.

The study, led by a team at King’s College London and St George’s, University of London, said they were “surprised at the lack of recent evidence” to support current dosing recommendations for penicillins.

Writing in the British Medical Journal (BMJ), they said ‘fractions’ of adult doses are calculated instead of basing the dose on the weight of the child who needs treatment.

The article said: “The widely used doses are still based on the original dosing principle of a big child = half an adult, small child = half a big child, baby half a small child.”

The team analysed the actual dose that would be received today based on age bands recommended in the 2010/11 British National Formulary for Children and the current weights of children based on 2009 Health Survey for England data.

The results showed doses could be strikingly low.

The authors also pointed out that many infections do not need treatment with antibiotics.

“Many of the five million children in England who receive oral penicillins each year may not need them, but those who do should receive them in an effective dose.”

Dr Paul Long, senior lecturer in pharmacognosy at King’s College London, said: “We were surprised at the lack of evidence to support the current oral penicillins dosing recommendations for children, as it is such a commonly used drug.

“Children’s average size and weight are slowly but significantly changing, so what may have been adequate doses of penicillin 50 years ago are potentially not enough today.

“It is important to point out that this study does not provide any clinical evidence that children are receiving suboptimal penicillin doses that lead to harm, and we want to reassure parents of that.

“But what we are saying is that we should ensure that children with severe infections who need these antibiotics the most are still receiving an effective dose.”

The first ever National Audit of Dementia found a “shocking” lack of care delivery.It found that care was often delivered in an impersonal manner, staff ignored patients’ requests for help and staff were not trained sufficiently in the care of dementia patients despite figures showing one in four hospital beds is occupied by people with the condition.

Data from 210 hospitals in England and Wales was used in the report along with ward level data from a sample of 145 wards, over 2,000 staff questionnaires and observations of care on the wards.

Professor Peter Crome, the co-author of the report and Chairman of the National Audit of Dementia Steering Group, said that the report had “found problems across practically every aspect of care for patients admitted to hospitals with dementia.”

He added: “There were deficiencies in the assessment of people and there were deficiencies in the interaction betweem staff and patients.”

Hannah Clack from the Alzheimer’s Society called the report “shocking” and stressed the need for “a huge and radical shake-up of the way the NHS deals with people with dementia.”

She added: “People are going into hospital and they’re coming out worse in terms of their dementia and in terms of their physical health.”

The report recommended that all staff should have basic training in dementia, and that all hospitals should have Dementia Champions on every ward.

Patients with hypertension, or chronic high blood pressure, are often given drugs to lower their risk of heart disease and stroke but the medication could also benefit a wider group of patients.Researchers found that people with prehypertension, where blood pressure is higher than normal but not as severe as in hypertension, had a 22 per cent lower risk of stroke if they took the drugs.

An analysis of 16 studies, covering 70,664 patients, found that treating 169 prehypertensive people with blood pressure-lowering medication for 4.3 years would prevent one stroke from happening.

High blood pressure is the biggest risk factor for stroke, and an estimated 40 per cent of strokes could be prevented if people took steps to control their blood pressure levels.

US data shows that about 10 per cent of Americans have prehypertension, with a blood pressure between 120/80mm Hg and 139/89mm Hg – higher than the upper boundary of “normal” but below the lower limit of hypertension.

Ilke Sipahi of the Harrington-McLaughlin Heart and Vascular Institute in Cleveland, Ohio, who led the study, published in the Stroke journal, said patients would be better off trying to lower their blood pressure through a healthy diet and physical activity than by taking pills.

He said: “We do not think that giving blood pressure medicine instead of implementing the lifestyle changes is the way to go … however, the clear-cut reduction in the risk of stroke with blood pressure pills is important and may be complementary to lifestyle changes.”

Dr Sharlin Ahmed of The Stroke Association said: “Making a few simple lifestyle choices, such as eating a healthy diet low in salt, giving up smoking, and exercising regularly can help to keep your blood pressure under control and can reduce your risk of stroke.

“As highlighted in this study, it may also be beneficial for some people with borderline high blood pressure to take blood pressure lowering medication, however this needs to be discussed with your GP.”

Professor Sir Michael Rawlins- head of the government’s medicines’ quango has said patients should sue their health trust if they are not getting the best recommended drugs.The killer quango- National Institute for Curbing Expenditure (NICE) was set up by labour to stop the NHS spending money on it’s drugs bill- so it’s unusual for him to speak out about NHS rationing.

Professor Rawlins, the chairman of NICE said the economic pressure on trusts meant that “completely illegal” decisions were being made to limit the use of expensive drugs.

He told the Financial Times: “I just wish a patient organisation would take a Trust to court for failing to comply.”

Nice has been criticised for ruling against the prescription of expensive new drugs on the grounds that they are not cost-effective.

But Sir Michael told the paper that most of Nice’s recommendations were in favour of prescription and that it was other bodies that blocked the drugs’ use.

Sir Michael criticised the local lists of approved medicines drawn up across the NHS which “second-guess” and sometimes ignore Nice recommendations.

While patient groups for particular diseases – often helped by pharmaceutical companies – have attacked Nice for advising against the use of some expensive new medicines, Sir Michael said they should be directing more criticism instead to the drug companies for charging high prices.

The government’s own innovation review recognised the problem by pledging a Nice “compliance regime” to reduce regional variation – the so-called “postcode lottery” – and to improve adherence to the agency’s guidelines.

It cautioned that local decisions should not act as a barrier to the medicines that Nice had approved.

Penny pinching NHS managers have introduced new viagra prescription guidelines which could limit thousands of couples to having sex once a fortnight.New policy documents advise GPs in parts of the country that patients in need of Viagra or similar drugs should be limited to two pills per month, down from the normal prescription of four.

Although the policy was described as a “recommendation” by NHS authorities, local medical committees told the GPs’ magazine Pulse in GPs slam secrecy over evidence for Viagra rationing restrictions it was being handed down to family doctors as an “edict”.

Erectile dysfunction medication is already stringently limited on the NHS and can only be prescribed to patients with certain conditions such as diabetes, multiple sclerosis and prostate cancer.

According to the NHS some 2.2 million prescriptions for erectile dysfunction drugs were issued last year, with 14.5 million tablets issued at a cost of about £78 million.

NHS guidance acknowledges that there “appears to be no clinical reason to restrict the number of tablets” but it adds that, according to research, the average person has sex four times a month.  The average frequency of sexual intercourse in the 40 to 60 age range is once a week.”

The new policy is aimed at economising on non-essential treatments, recommending that the minimum effective dose be prescribed “two times per month using the drug with the lowest acquisition cost.”

The guidance applies to sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis).

Richard Hoey, editor of Pulse, said: “Ask most doctors and they will say that being able to live a satisfactory sex life is a key part of health and wellbeing, but the NHS has never recognised that in its policy on treatment for erectile dysfunction.

“Limiting patients to drugs like Viagra just twice a month is to treat sex like an unnecessary luxury, and completely fails to recognise the degree of anguish it can cause some men with erectile dysfunction.”

Erectile dysfunction is very common in middle aged and older men, with an estimated 50 per cent of those between 40 and 70 experiencing the condition to some degree.

Viagra and other medications can be bought privately, but the cost of about £40 for eight pills can be prohibitive, and patients must also pay for a private prescription.

The new prescription guidelines were drawn up by South Central Priorities Committees, which covers primary care trusts (PCTs) in Milton Keynes, Oxfordshire, Berkshire East, Berkshire West and Buckinghamshire.

Almost half of cancers are caused by an unhealthy lifestyle that could be avoided by quitting smoking, losing weight, exercising and drinking less alcohol, the most comprehensive study of its kind has found.Around 134,000 cancers each year are the result of a poor lifestyle, Cancer Research UK has found.

In the most wide reaching study yet conducted into the issue, it was found that 14 different lifestyle factors ranging from smoking, to lack of exercise, eating too much salt, not having babies, drinking too much and being overweight contributed to four in every ten cancers diagnosed in the UK.

The findings expose the myth that developing cancer is ‘bad luck’ or down to your genes, the researchers said.

Previous studies had suggested around 80,000 cancers a year could be prevented but they did not take into account occupational exposures to things like asbestos, infections that can cause cancer and sunburn as the latest research has.

In a complex set of research studies, scientists calculated how many cancers and of what type could be attributed to each of the 14 lifestyle factors.

The findings of the research The Fraction of Cancer Attributable to Lifestyle and Environmental Factors in the UK were published in the British Journal of Cancer.

Smoking was the biggest factor, causing nearly one in five of all cancers.

But Harpal Kumar, chief executive of Cancer Research UK, said most people would not know that a quarter of all breast cancer cases could be prevented along with half of colorectal cancers.

He added: “Leading a healthy lifestyle doesn’t guarantee that someone will not get cancer but doing so will significantly stack the odds in your favour.”

Dr Kumar said tackling unhealthy lifestyle factors linked to cancer would also reduce the risk of a host of other killer diseases such as heart disease, respiratory problems, kidney disease and others.

The study found that alcohol was responsible for 6.4 per cent of breast cancers and almost one in ten liver cancers.

Three quarters of stomach cancers could be avoided, mostly by not smoking, eating too much salt and consuming more fruit and vegetables.

Red meat consumption led to 2.7 per cent of cancers, almost 8,500 cases. Obesity was linked to more than five per cent of cancers or almost 18000 cases, including a third of womb cancers.

Lack of breastfeeding was linked to 3.1 per cent of breast cancers and 17 per cent of ovarian cancers.

The study did not examine how many cancer deaths would be prevented with a healthier lifestyle.

Sara Hiom, director of information at Cancer Research UK, said: “We know, especially during the Christmas party season, that it is hard to watch what you eat and limit alcohol and we don’t want people to feel guilty about having a drink or indulging a bit more than usual. But it’s very important for people to understand that long term changes to their lifestyles can really reduce their cancer risk.”

The World Cancer Research Fund did a similar exercise in 2007 coming up with recommendations to individuals on how to reduce their cancer risk by eating less red meat, taking more exercise and staying slim.

Dr Rachel Thompson, Deputy Head of Science for World Cancer Research Fund, said: “This adds to the now overwhelmingly strong evidence that our cancer risk is affected by our lifestyles.

“We hope this new study helps to raise awareness of the fact that cancer is not simply a question of fate and that people can make changes today that can reduce their risk of developing cancer in the future.”

Alcohol drinkers should have two alcohol free days every week warn MPs- who claim current guidelines give the false impression that daily consumption is healthy.The Science and Technology Committee says current advice on “regular” safe intake is confusing, and wrongly leads people to believe that enjoying a few pints of beer or glasses of wine every day will not harm health.

It wants the Department of Health in England to carry out the first proper review of drinking guidance in more than 15 years, which should follow the example of Scotland in recommending two “dry” days a week.

The MPs also want new rules on what would count as a dangerous night of “binge-drinking”, new lower safe levels for older people and a website where people can work out individual intake based on their age, weight and family history.

They say few people understand what constitutes an alcoholic unit, the basis of the drinking advice, and tell ministers that the guidelines do not seem to change behaviour.

Although the Committee’s report concedes that the drinks industry is needed to help improve labelling on bottles and glasses, it warns of potential conflicts of interest if the Government works too closely with brewers and shops.

Andrew Miller, the Committee’s chairman, said: “Alcohol guidelines are a crucial tool for Government in its effort to combat excessive and problematic drinking. It is vital that they are up-to date and that people know how to use them.

“Unfortunately, public understanding of how to use the guidelines and what an alcohol unit looks like is poor, although improving.

“While we urge the UK Health Departments to re-evaluate the guidelines more thoroughly, the evidence we received suggests that the guidelines should not be increased and that people should be advised to take at least two drink-free days a week.”

The MPs’ report, published on Monday following public hearings and written submissions last year, states that the first Government health advice on sensible drinking was not published until the 1980s.

Originally, the public were told that men could safely have 18 “standard drinks” a week and women half that number, while in 1987 this was revised in favour of weekly “sensible limits” of 21 units for men and 14 for women.

Medical research later suggested that moderate daily alcohol intake could be good for the health, by lowering levels of bad cholesterol in the blood, while giving weekly limits could “mask episodes of heavy drinking”. In 1995, therefore, daily limits were introduced that recommended men should not drink more than three to four units a day, and women two to three.

Some experts, however, raised concerns that this switch from weekly to daily limits appeared to increase the weekly “allowance” of alcohol while also appearing to “endorse daily drinking”.

The MPs say more recent studies have cast doubt on the health benefits of regular drinking, and recommend that England follows Scotland’s lead in urging “at least two alcohol-free days a week”.

They back current specific advice for children and pregnant women, and say “there could be merit” in producing new rules for older people as well as limits for “individual drinking episodes”, but find no evidence for increasing current general safe limits.

The Committee says an expert group, including civil servants as well as scientists, should review current evidence on the health effects of alcohol in order to “increase public confidence”.

They say people should be made aware of the difference between the short-term effects of binge drinking and the long term harm caused by alcoholism, and should be helped to understand how many units are in different drinks.

The number of people being admitted to hospital after drinking too much alcohol has more than doubled in less than a decade, new research show.Some 1,173,386 people in England were admitted to casualty for injuries or illnesses caused by drinking in 2010/11, compared with just 510,780 in 2002/3, according to the research.

The figures for last year represent an 11 per cent increase on the previous 12 months, when alcohol-related admissions stood at 1,056,962.

Separate information published by Anne Milton, the public health minister, showed that since January an estimated 7,074 under-18s have been admitted to hospital due to alcohol abuse.

A recent report predicted that binge drinking will cost the NHS £3.8 billion by 2015, with 1.5 million A&E admissions a year.

Andrew Lansley, the Health Secretary, blamed Labour’s 24-hour drinking policy and accused the last government of “taking their eye of the ball” on the issue of binge drinking.

He said: “These figures are disturbing evidence that, despite total consumption of alcohol not increasing recently, we have serious problems with both binge-drinking and long-term excessive alcohol abuse in a minority of people.

“Our alcohol strategy, which we will set out in the new year, will outline what further steps we are taking to tackle this growing problem.”

Recent Local Alcohol Profiles for England figures also show that the number of hospital admissions for conditions attributable to alcohol are rising at a similar rate.

The number of admissions has more than doubled since 2002/03 and increased by nine per cent last year.

In 2002/03 there were 926 admissions per 100,000 people for conditions caused by alcohol, rising to 1,743 per 100,000 in 2009/10 and 1,898 last year.

The biggest increase over the past 12 months was in London, with a jump in admissions of 14 per cent, followed by the East of England with 10 per cent.