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South 18 Woodham Focus
South Woodham Focus
NEW ASTHMA TREATMENT: Laura Foster reporting for the BBC
tells us that "A new treatment for severe asthma is set to be
made more widely available on the NHS in the UK by the end of
2018. The procedure, bronchial thermoplasty, "melts" away
excess muscle tissue in the lungs using radio frequency, making
breathing easier. Previously there were strict criteria about who
was eligible to receive it. But the National Institute for Health
and Care Excellence (Nice) says it can be offered more routinely,
after it was proved to be safe and effective."
Here's the sting in the tail - LF says that: "Some people may still
not be able to receive it because the final decision about
whether to offer the procedure lies with local health bodies." In
this part of the world the funding for healthcare puts us very
close to the bottom of the league (NHS cash, in case you don't
already know, is not distributed fairly or equally) so we are likely
to be losers in this particular postcode lottery.
Asthma UK explains Bronchial Thermoplasty (BT) in a fairly user
friendly way. We're told that BT is a treatment suitable for some
adults with severe asthma. It's a hospital procedure, not a
medicine. It helps to open up the lungs and make breathing
easier by applying heat using radiofrequency to the inside of the
airways. This is done because asthma causes the lining of the
airways to become inflamed and swollen, narrowing the airways
over time, and making it harder to breathe. In people with
severe asthma this inflammation can eventually cause thickening
of the smooth muscle tissue in the airways, which narrows them
and makes it harder for air to pass through them. BT reduces the
amount of this smooth muscle tissue in the airway walls, making
it less likely that the airways will become narrow in the future.
As for 'suitable cases for treatment ... BT is a possible treatment
option if you’re 18 or older, with severe asthma, and you’re
taking all the relevant medicines for your asthma, exactly as
prescribed, but are still having symptoms. Following discussion
you will be told if you 'fit the criteria' and, just as importantly,
you'll decide if it's the right option for you.
As for possible benefits, BT is not a 'cure' for asthma, so it's likely
you'll have to carry on taking your asthma medicines after
having this treatment. In studies, when people who've had BT
were asked about how much asthma affected their life after the
treatment, they reported some improvement. Research has also
found people who have had BT may use their reliever inhaler
(usually blue) less often. But the long-term risks and benefits of
BT aren't yet fully understood as BT hasn't been around for a
long time and more evidence is needed. The usual word of
caution - unfortunately, BT doesn't work for everyone.
"People say that money is not the key to happiness, but I always
figured if you have enough money, you can have a key made."
Joan Rivers
MEASLES and SNEEZLES. Some time ago Sister Sue and Sister
Katrina wrote to the parents of children who hadn't had all their
recommended vaccinations to remind them that their kids were
at risk given that, during the holiday season, lots of people go
abroad to escape the cold bleak English summer. We were
getting reports of a outbreaks of measles elsewhere in Europe
and we didn't want any of our young patients to become 'a
statistic.'
Here's the background. Sarah Boseley, Health Editor of The
Guardian, wrote on 2nd August that: "A huge surge in measles
cases across Europe has been reported by the World Health
Organisation, which says low MMR vaccination rates are to
blame. More than 41,000 cases of measles have been reported in
the European region between January and June. Last year there
were nearly 24,000 for the whole 12 months, which was the
highest count in any year of the last decade."
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She quoted 'an expert': “We are seeing a dramatic increase in
infections and extended outbreaks,” said Dr Zsuzsanna Jakab,
WHO regional director for Europe. “We call on all countries to
immediately implement broad, context-appropriate measures to
stop further spread of this disease.”
Sarah B goes on to say: "In seven countries (France, Georgia,
Greece, Italy, the Russian Federation, Serbia and Ukraine) more
than 1,000 children and adults have been infected in the first
half of 2018 and at least 37 people have died. The biggest toll
was in the Ukraine, which had 23,000 cases – half the European
total. There were measles-related deaths in all seven countries.
Serbia, with 14, had the most."
She reminds us of the history behind this less than satisfactory
situation: "Confidence in the MMR (measles, mumps and rubella)
jab slumped after the gastroenterologist Andrew Wakefield at
the Royal Free hospital in London published a paper in the
Lancet in 1998 wrongly alleging a link between the vaccine and
autism. The paper was retracted and Wakefield, who had not
declared he was taking money from solicitors hoping to pursue
vaccine damage cases, was struck off the medical register for
dishonesty and irresponsibility. Take-up of the MMR by parents
for their children recovered across Europe, but there have been
pockets of hesitancy and denial in every country, creating areas
in which the general immunisation rate is too low to protect
unvaccinated children.
The European Centre for Disease Prevention and Control rubs
salt into the wound: "Measles is a severe disease and since the
beginning of 2016, 57 deaths due to the disease have been
reported in the EU."
Q: Do you know why beer goes through your system so fast?
A: Because it doesn't have to stop to change colour.
Wakefield is a charlatan - so why do his ideas still exert influence.
Harriet Alexander in The Telegraph has one answer. "Russian
trolls and social media bots set out to pour fuel on the fire of
debate about vaccines, a new study has found. Researchers at
George Washington University in Washington DC found that,
using tactics similar to those seen during the 2016 presidential
election, a series of Twitter accounts set out to sow discord. The
accounts tweeted both pro- and anti-vaccine messages, in an
apparent attempt to stir up a fierce debate, while bots that
spread malicious software appeared to use anti-vaccine messages
that inflame strong responses from both sides to attract clicks.
As is usual in these cases she quotes an expert: "The vast majority
of Americans believe vaccines are safe and effective, but looking
at Twitter gives the impression that there is a lot of debate," said
David Broniatowski, an assistant professor at the School of
Engineering and Applied Science. "It turns out that many antivaccine
tweets come from accounts whose provenance is unclear.
These might be bots, human users or 'cyborgs' - hacked accounts
that are sometimes taken over by bots. Although it's impossible
to know exactly how many tweets were generated by bots and
trolls, our findings suggest that a significant portion of the
online discourse about vaccines may be generated by malicious
actors with a range of hidden agendas."
If you still have any doubts as to who has right on their side
when it comes to 'the vaccination debate', then go to the oracle.
President Trump is usually wrong, whatever the subject, and he
has tweeted on numerous occasions that there is a link between
childhood vaccinations and autism (thereby contradicting the
advice of his own experts). I rest my case.
Dr John