The smoking ban has led to a sharp fall in heart attacks

Major research suggests that the introduction of a smoking ban has resulted in a 40 per cent fall in the number of people suffering from heart attacks as the result of passive smoking.

Major research suggests that the introduction of a smoking ban has resulted in a 40 per cent fall in the number of people suffering from heart attacks as the result of passive smoking
Heart attack rates in the UK have fallen by up to 42 per cent since the 2007 smoking ban, major research suggests.

A review of 77 studies found that reduced exposure to passive smoking has caused a “significant reduction” in heart problems across the population.

Several of the studies found that non smokers and ex-smokers gained most the benefits.

The Cochrane study examined a range of health outcomes in 21 countries, including the UK, which have introduced bans in recent years.

Researchers concluded that there was strong evidence that reduced exposure to passive smoking reduced the number of people suffering from cardiac problems.

The studies examined included a Liverpool study of 57,000 hospital patients. This found admissions for heart attacks fell by 42 per cent among men and 43 per cent among women in the five years since the ban was introduced in 2007.

And US research reviewed found a 14 per cent reduction in strokes in counties which introduced a ban, compared with those which did not.

Some 33 out of the 44 studies reviewed on heart disease found a “significant reduction” following the introduction of smoking bans.

Researchers said the studies took account of other trends over the period – such as a large increase in rates of statin prescribing, to protect against heart disease.

Review author, Professor Cecily Kelleher, from University College, Dublin, said: “The current evidence provides more robust support for the previous conclusions that the introduction of national legislative smoking bans does lead to improved health outcomes through a reduction in second hand smoke exposure for countries and their populations.”

Professor Peter Weissberg, medical director of the British Heart Foundation, said: “This review strengthens previous evidence that banning smoking in public places leads to fewer deaths from heart disease and that this effect is greatest in the non-smoking population.

He said the studies were observational and all had their limitations, but it would be difficult to study the effects of passive smoking in a more robust scientific way.

Researchers said the evidence was less clear about whether the introduction of bans had actually helped people to give up smoking.

Nonetheless, smokers seemed to benefit from some reduction in exposure to passive smoke.

One Scottish study, which found no fall in smoking rates after a ban was introduced in 2006, found a 14 per cent reduction in hospital admissions for heart problems among smokers, and a 21 per cent reduction in admissions among non-smokers.

The research found the impact of the ban on respiratory health, and conditions such as asthma, was less clear cut, though seven of 12 studies on asthma found reduced hospitalisations since the ban.

Suicide gene therapy kills prostate cancer cells

A new gene therapy technique is able to modify prostate cancer cells so that a patient’s body attacks and kills them, US scientists have discovered.

A new gene therapy technique is able to modify prostate cancer cells so that a patient's body attacks and kills them, US scientists have discovered.

The technique causes the tumour cells in the body to self destruct, giving it the name ‘suicide gene therapy’.

Their research found a 20% improvement in survival in patients with prostate cancer five years after treatment.

Prostate cancer is the most common cancer in men in the UK with more than 41,000 diagnosed each year.

The study, led by researchers from Houston Methodist Hospital in Texas, appears to show that this ‘suicide gene therapy’, when combined with radiotherapy, could be a promising treatment for prostate cancer in the future.

The technique involves the cancer cells being genetically modified so that they signal a patient’s immune system to attack them.

Usually, the body does not recognise cancer cells as the enemy because they have evolved from normal healthy cells. Unlike an infection, which the body reacts against, the immune system does not react to kill off the offending cancer cells.

Using a virus to carry the gene therapy into the tumour cells, the result is that the cells self destruct, alerting the patient’s immune system that it is time to launch a massive attack.

In two groups of 62 patients, one group received the gene therapy twice and the other group – who all had more aggressive prostate cancer – received the treatment three times. Both groups also received radiotherapy.

Survival rates after five years were 97% and 94%. Although there was no control group in this study, the researchers said the results showed a five to 20% improvement on previous studies of prostate cancer treatment.

And cancer biopsy tests performed two years after the trial were found to be negative in 83% and 79% of the patients in the two groups.

Dr Brian Butler, from Houston Methodist Hospital in Texas, said it could change the way that cancer is treated. “We may be able to inject the agent straight into the tumour and let the body kill the cancer cells. Once the immune system has knowledge of the bad tumour cells, if they pop up again, the body will know to kill them.”

Kevin Harrington, professor of biological cancer therapies at The Institute of Cancer Research, London, said the results were “very interesting” but more research was needed. We would need a randomised trial to tell if this treatment is better than radiotherapy alone.”

“The viruses used in this study cannot reproduce. Next generation viral therapies for cancer can selectively replicate in cancer cells, something that can kill the cancer cell directly, and also help spread the virus to neighbouring cancer cells.”

“It would be interesting to see this approach used with viruses that could reproduce to see if it makes for a more effective treatment.”

NHS trust failed to investigate hundreds of deaths

The NHS has failed to investigate the unexpected deaths of more than 1,000 people since 2011 according to a new report.

The NHS has failed to investigate the unexpected deaths of more than 1,000 people since 2011 according to a new report.

It blames a “failure of leadership” at Southern Health NHS Foundation Trust and that the deaths of mental health and learning disability patients were not properly examined.

Southern Health said it “fully accepted” the quality of processes for investigating and reporting a death needed to be better, but had improved.

The trust is one of the country’s largest mental health trusts, covering Hampshire, Dorset, Wiltshire, Oxfordshire and Buckinghamshire and providing services to about 45,000 people.

The investigation, commissioned by NHS England and carried out by Mazars, a large audit firm, looked at all deaths at the trust between April 2011 and March 2015.

During that period, it found 10,306 people had died. Most were expected. However, 1,454 did not.

Of those, 272 were treated as critical incidents, of which just 195 – 13% – were treated by the trust as a serious incident requiring investigation (SIRI).

The likelihood of an unexpected death being investigated depended hugely on the type of patient.

The most likely group to see an investigation was adults with mental health problems, where 30% were investigated. For those with learning disability the figure was 1%, and among over-65s with mental health problems it was just 0.3%.

The average age at death of those with a learning disability was 56 – over seven years younger than the national average.

Even when investigations were carried out, they were of a poor quality and often extremely late, the NHS England report says.

Repeated criticisms from coroners about the timeliness and usefulness of reports provided for inquests by Southern Health failed to improve performance, while there was often little effort to engage with the families of the deceased.

Key findings from the report

  • The trust could not demonstrate a comprehensive systematic approach to learning from deaths
  • Despite the trust having comprehensive data on deaths, it failed to use it effectively
  • Too few deaths among those with learning disability and over-65s with mental health problems were investigated, and some cases should have been investigated further
  • In nearly two thirds of investigations, there was no family involvement

The reasons for the failures, says the report, lie squarely with senior executives and the trust board.

There was no “effective” management of deaths or investigations or “effective focus or leadership from the board”, it says.

Even when the board did ask relevant questions, the report says, they were constantly reassured by executives that processes were robust and investigations thorough.

The culture of Southern Health, which has been led by Katrina Percy since it was created in 2011, “results in lost learning, a lack of transparency when care problems occur, as well as lack of assurance to families that a death was not avoidable and has been properly investigated,” the report says.

Antibiotic resistance- world on cusp of post antibiotic era

The world is on the cusp of a “post-antibiotic era”, scientists have warned after finding bacteria resistant to drugs used when all other treatments have failed.

The world is on the cusp of a "post-antibiotic era", scientists have warned after finding bacteria resistant to drugs used when all other treatments have failed

They identified bacteria able to shrug off the drug of last resort – colistin – in patients and livestock in China.

They said that resistance would spread around the world and raised the spectre of untreatable infections. It is likely resistance emerged after colistin was overused in farm animals.

Bacteria becoming completely resistant to treatment – also known as the antibiotic apocalypse – could plunge medicine back into the dark ages.

Common infections would kill once again, while surgery and cancer therapies, which are reliant on antibiotics, would be under threat.

Chinese scientists identified a new mutation, dubbed the MCR-1 gene, that prevented colistin from killing bacteria.

The report in the Lancet Infectious Diseases showed resistance in a fifth of animals tested, 15% of raw meat samples and in 16 patients.

And the resistance had spread between a range of bacterial strains and species, including E. coli, Klebsiella pneumoniae and Pseudomonas aeruginosa.

There is also evidence that it has spread to Laos and Malaysia.

Resistance to colistin has emerged before. However, the crucial difference this time is the mutation has arisen in a way that is very easily shared between bacteria.

The concern is that the new resistance gene will hook up with others plaguing hospitals, leading to bacteria resistant to all treatment – what is known as pan-resistance.

Early indications suggest the Chinese government is moving swiftly to address the problem.

New drugs are in development, such as teixobactin, which might delay the apocalypse, but are not yet ready for medical use.

A commentary in the Lancet concluded the “implications [of this study] are enormous” and unless something significant changes, doctors would “face increasing numbers of patients for whom we will need to say, ‘Sorry, there is nothing I can do to cure your infection.'”

Healthier lifestyles could cut cancer cases by a third

About a third of cancer cases in the UK could be prevented if people ate healthily, exercised more and cut down on alcohol according to new research.

About a third of cancer cases in the UK could be prevented if people ate healthily, exercised more and cut down on alcohol according to new research
Exercise is an important way of keeping fit and cutting body fat, which is linked to the risk of developing cancer.

Data from the World Cancer Research Fund suggests that 20,000 cases of breast cancer and about 19,000 cases of bowel cancer could be stopped each year with small changes in lifestyle.

In 2013, there were more than 351,000 new cases of cancer in the UK. The WCRF said 84,000 could have been prevented.

Head of research Dr Rachel Thompson said simple changes to diet and lifestyle could make “a huge difference” in the battle against cancer.

“Even minor adjustments, like 10 to 15 extra minutes of physical activity each day, cutting down on alcohol, or limiting your intake of high calorie foods and sugary drinks, will help decrease your cancer risk,” she said.

She said that after cutting out smoking, being a healthy body weight was the most important thing people could do to cut their risk of getting cancer.

“There is strong evidence that being overweight or obese increases the risk of 10 cancers,” she said.

The link between a healthy lifestyle and the risk of developing cancer is well known, and this new data looks at preventable cases in 13 of the UK’s most common cancers.

For example, among men, 9% of cases of advanced prostate cancer could be prevented every year if men were not overweight or obese.

Lung cancer cases could be cut by 15,000 (33%) by getting people to stop smoking.

And 38% of breast cancer cases could be prevented, particularly in postmenopausal women, by increasing physical exercise and reducing body fat.

The WCRF also said that 2,200 cases of kidney cancer and 1,400 cases of pancreatic cancer could be prevented if people adopted a healthier lifestyle.

Prof Kevin Fenton, director of health and wellbeing at Public Health England, said the UK was currently behind on cancer survival rates compared with other European countries.

He said one major factor was that cancer prevention was not in the public consciousness.

“The link between tobacco and cancer is widely known and readily accepted by the public, but many are not yet fully convinced that healthy eating, regular exercise and not drinking alcohol, can lower your cancer risk.”

From: https://www.fithealthylives.com/2016/06/healthier-lifestyles-could-cut-cancer-cases-by-a-third-2/

Sugar Tax- how will it work?

A new sugar tax on the soft drinks will be introduced in the UK the chancellor announced yesterday.

A new sugar tax on the soft drinks will be introduced in the UK the chancellor announced yesterdayThe move has been hailed by campaigners as a significant step in the fight against child obesity.

So how will the sugar tax work?

The levy is squarely aimed at high sugar drinks- particularly fizzy drinks, which are popular among teenagers.

Pure fruit juices and milk based drinks will currently be excluded and the smallest producers will have an exemption from the scheme.

It will be imposed on companies according to the volume of the sugar sweetened drinks they produce or import.

There will be two bands – one for total sugar content above 5g per 100 millilitres and a second, higher band for the most sugary drinks with more than 8g per 100 millilitres. Analysis by the Office for Budgetary Responsibility suggests they will be levied at 18p and 24p per litre.

Examples of drinks which would currently fall under the higher rate of the sugar tax include full strength Coca-Cola and Pepsi, Lucozade Energy and Irn-Bru, the Treasury said. The lower rate would catch drinks such as Dr Pepper, Fanta, Sprite, Schweppes Indian tonic water and alcohol free shandy.

When it comes to the sugar tax, all the emphasis has been on drinks. There are a number of reasons for this.

Firstly, unlike a chocolate bar or slice of cake, they are not automatically seen as a treat. People who drink them tend to have them every day.

Secondly, some of the drinks are incredibly high in sugar. A typical can contains enough sugar – about nine teaspoons – to take someone over their recommended sugar intake in one hit.

For teenagers they are the number one source of sugar intake while overall, children get a third of their daily sugar intake from them.

They have also been dubbed “empty calories” as they have no nutritional benefit.

Mr Osborne said the money raised – an estimated £520 million a year, will be spent on increasing the funding for sport in primary schools.

There has been pressure on ministers to increase spending in this area to build on the legacy of the 2012 Olympic Games and in light of the low numbers of children who take part in regular activity.

But while the tax applies to the whole of the UK, Mr Osborne announcement on where the money is spent applies solely to England. The devolved administrations in Scotland, Wales and Northern Ireland are free to decide how to spend their share.

The issue has been described as one of the most serious public health challenges for the 21st Century by the World Health Organization, while NHS England’s Simon Stevens has dubbed it “the new smoking”.

Health Direct applauds this new initiative and is sure that this will be just the start. Mr Osbourne has a habit of returning to existing taxes and constantly increasing them- like to tobacco and wine.

Good News on World Cancer Day

The cancer death rate for men fell by 12% and for women 8% between 2003 and 2013.

The cancer death rate for men fell by 12% and for women 8% between 2003 and 2013

In 2013, 284 out of every 100,000 people died from cancer. In 2003, it was 312. Improvements in diagnosis and treatment are thought to be the reason.

The death rate for men fell 12% and for women by 8%, narrowing the gender gap.

But the actual number of cancer deaths rose – from 155,000 in 2003 to 162,000 in 2013 – as more people live longer and develop the disease in old age.

“The population is growing, and more of us are living longer,” Cancer Research UK chief executive Sir Harpal Kumar said.

Almost half of all the cancer deaths in 2013 were from lung, bowel, breast or prostate cancer.

Although the combined death rate for these four cancers had dropped by about 11% over the past 10 years, some other cancers, such as liver and pancreatic, had increased death rates.

Sir Harpal said: “Too many people are still being diagnosed with and dying from cancer, not just here in the UK but around the world.”

He said CRUK was focusing research on how to achieve earlier diagnosis and manage hard-to-treat cancers.

“Our scientists are developing new tests, surgical and radiotherapy techniques, and drugs,” he said.

“It’s important to celebrate how much things have improved, but also to renew our commitment to saving the lives of more cancer patients.”

Cancer Research UK compiled the cancer death rate data, which was taken from cancer registries in England, Wales, Scotland and Northern Ireland.

Health Direct cheers the great news that half of cancer sufferers now survive the diagnosis.

David Bowie thanked by end of life care doctor

A doctor specialising in end of life care has  thanked David Bowie helping people to talk about death.

A doctor specialising in end of life care has thanked David Bowie helping people to talk about deathDr Mark Taubert, palliative care consultant at Velindre NHS Trust in Cardiff, said it prompted a “weighty” discussion with a dying woman.

His letter, published on the blogs website page of the British Medical Journal (BMJ), has been retweeted by Bowie’s son, Duncan Jones.

The singer died from cancer aged 69.

Mr Jones had not tweeted since confirming his father’s death, which happened in New York on 10 January.

But he retweeted a link to the letter, where Dr Taubert described the conversation he had with the woman after she had been told her cancer had spread and that she would not live much longer than a year.

Starting the letter with “Dear David”, Dr Taubert wrote: “We discussed your death and your music, and it got us talking about numerous weighty subjects, that are not always straightforward to discuss with someone facing their own demise.

“In fact, your story became a way for us to communicate very openly about death, something many doctors and nurses struggle to introduce as a topic of conversation.”

He went on: “We talked about palliative care and how it can help.

“She told me about her mother’s and her father’s death, and that she wanted to be at home when things progressed, not in a hospital or emergency room, but that she’d happily transfer to the local hospice should her symptoms be too challenging to treat at home.

“We both wondered who may have been around you when you took your last breath and whether anyone was holding your hand.

“I believe this was an aspect of the vision she had of her own dying moments that was of utmost importance to her, and you gave her a way of expressing this most personal longing to me, a relative stranger.”

Dr Taubert also said dying at home and the last photos of Bowie carrying “off a sharp suit” would help people deal with any fears they had about the last weeks of life.

“You looked great, as always, and it seemed in direct defiance of all the scary monsters that the last weeks of life can be associated with,” he added.

UK end of life care- best in world

End of life care in the UK has been ranked as the best in the world with a study praising the quality and availability of services.

End of life care in the UK has been ranked as the best in the world with a study praising the quality and availability of servicesThe study of 80 countries said thanks to the NHS and hospice movement the care provided was “second to none”.

Rich nations tended to perform the best – with Australia and New Zealand ranked second and third respectively.

But the report by the Economist Intelligence Unit praised progress made in some of the poorest countries.

For example Mongolia – ranked 28th – has invested in hospice facilities, while Uganda – 35th – has managed to improve access to pain control through a public-private partnership.

The rankings were worked out following assessments for the quality of the hospitals and hospice environments, staffing numbers and skills, affordability of care and quality of care.

Just 34 out of 80 countries provided what could be classed as good end-of-life care – and these accounted for just 15% of the adult population.

The report said the quality of end-of-life care was becoming increasingly important with the ageing population, meaning people were increasingly facing “drawn-out” deaths.

It’s no major surprise that richer countries, with stronger health systems, provide some of the world’s best palliative care. But a few poorer nations are bucking the trend, and it’s often down to the efforts of individuals campaigning for everyone to be allowed a dignified and pain-free death. Panama, Chile, Mongolia and Uganda are singled out for praise, whereas the situation in India and China is described as “worrying”.

India ranked 67th in the index, and China was in the bottom 10 at 71. Both have huge populations and have experienced rapid economic growth, but care for people at the end of their lives has not kept up. The report warns further improvements are needed across all countries to cope with the future demands of an aging population, increasingly facing drawn-out illnesses such as cancer, heart disease and dementia.

The UK received top marks for affordability – as would be expected for a service that is provided free at the point of need – but also got a perfect score for quality of care.

Overall it was given 93.9 out of 100, but the report still said there was room for improvement – as there was with all the top-performing nations.

Services in England have recently been criticised by the Parliamentary and Health Service Ombudsman.

The UK also came top the last time this report was produced in 2010. Also in the top 10 this time were the Irish Republic, France, Germany and the US.

Iraq and Bangladesh finished bottom of the ranking, while China was in the worst 10.

Assisted Dying Bill- MPs reject right to die law

MPs have rejected plans for a right to die in England and Wales in their first vote on the issue in almost 20 years.

Assisted Dying Bill- MPs reject right to die law
In a free vote in the Commons, 118 MPs were in favour and 330 against plans to allow some terminally ill adults to end their lives with medical supervision.

In a passionate debate, some argued the plans allowed a “dignified and peaceful death” while others said they were “totally unacceptable”.

Pro-assisted dying campaigners said the result showed MPs were out of touch.

Under the proposals, people with fewer than six months to live could have been prescribed a lethal dose of drugs, which they had to be able to take themselves. Two doctors and a High Court judge would have needed to approve each case.

But Sarah Wootton, the chief executive of Dignity in Dying, said it was an “outrage” that MPs had gone against the views of the majority of the public who supported the bill.

A series of high profile and emotionally charged right to die cases have appeared in the courts.

But the response from judges has been clear. As Lord Justice Toulson ruled in the case of Tony Nicklinson: “These are matters for Parliament to decide.”

Now the message from politicians has been an overwhelming rejection of the right to die.

And opinion is not shifting – 74% of MPs voted against this bill compared with 72% back in 1997. The emphatic nature of the result would suggest politicians are unlikely to discuss this again soon.

Campaigners will regroup and point to their own polls showing 82% of the public back assisted dying and calls for change may yet intensify with an ageing population.

The latest proposals were brought before the Commons by Rob Marris, the Labour MP for Wolverhampton South West.

Opening the debate, Mr Marris said the current law did not meet the needs of the terminally ill, families or the medical profession.

He said there were too many “amateur suicides, and people going to Dignitas” and it was time for Parliament to debate the issue because “social attitudes have changed”.

Mr Marris added: “This bill would provide more protection for the living and more choice for the dying.”

Mr Marris said he did not know what choice he would make if he was terminally ill, but said it would be comforting to know that the choice was available.

Euthanasia, which is considered as manslaughter or murder, is illegal under English law.

The Suicide Act 1961 makes it an offence to encourage or assist a suicide or a suicide attempt in England and Wales. Anyone doing so could face up to 14 years in prison. The law is almost identical in Northern Ireland.

There is no specific law on assisted suicide in Scotland, creating some uncertainty, although in theory someone could be prosecuted under homicide legislation.

In a lengthy speech, Labour MP Sir Keir Starmer told MPs about prosecution guidelines he developed in his role as director of public prosecutions, when he had to deal with a number of “right to die” cases, including those of Debbie Purdy and Tony Nicklinson.

But he warned that his guidelines had shortcomings without a change in the law.

He said: “We have arrived at a position where compassionate amateur assistance from nearest and dearest is accepted, but professional medical assistance is not unless you have the means of physical assistance to get to Dignitas.

The British Medical Association, the doctor’s union, opposes all forms of assisted dying whilst the Royal College of Nursing takes a neutral stance.