OVERDIAGNOSIS: TOO MUCH MEDICINE?

With the aim to diagnose, treat and help people, there is evidence to show that ‘overdiagnosis’ plays a much larger role in this than it should. Overdiagnosis is when a person is labelled or treated for a disease however the disease would not actually cause them significant harm and can lead to the overuse of further tests and treatment.

For example over 500 000 people are estimated to have received overdiagnosis for thyroid cancer across 12 countries in the last 20 years. This leads them to often having surgery and lifelong medication which is not actually needed in the first place.

Some of the key points to do with over diagnosis include:

  • Interest is growing in tackling the problems of overdiagnosis and over treatment
  • Possible drivers and potential solutions arise across five inter- related domains: culture, the health system, industry and technology, healthcare professionals, and patients and the public
  • More work is needed to develop and evaluate interventions aimed at preventing overdiagnosis
  • Raising public awareness of overdiagnosis is a priority

-BMJ 23rd September 2017, 358:421-462 No 8122 / CR ISSN 0959-8138

A main reason for this overdiagnosis is that there are many fears of uncertainty, ageing, death and disease, and in many cultures people believe that in healthcare ‘more is better’, when this is not necessarily always the case.

Possible solutions for this include public awareness and education campaigns to challenge this common belief in healthcare that ‘more is better’. Another possible solution for this is through bringing in incentives for medical professionals to be rewarded based on the quality of their care rather than the quantity of their care.

I understand that the intentions of medical proffessionals are to do what is best for us and that we are brought up in a culture which believes that doing ‘something’ in healthcare is better than doing ‘nothing’, and in the majority of cases this is true. However I also think that it is important that this issue of overdiagnosis is addressed and people are made aware of it so that they can be cautious of the medical treatment that they do received and are fully informed on the extent to which their conditions need to be treated.

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Is coffee GOOD or BAD for you?

5 Reasons why coffee is good for you

  1. It boosts your mood– a study found that woman who drank four or more cups of coffee every day were 20 percent less likely to suffer from depression, coffee drinkers were half as likely to attempt suicide
  2. Helps ward off diabetes– people who drink a lot of coffee are less likely to develop type 2 diabetes than people who drink smaller amounts, or no coffee at all, according to some studies due to it containing ingredients that lower blood sugar
  3. Protects Your Heart- Two or more cups of coffee each day could protect against heart failure, according to one Harvard Study
  4. Good for Parkinson’s– studies have shown that the caffeine in coffee could help people who have Parkinson’s disease manage their uncontrollable movements. Others have shown that having a higher intake of coffee is associated with a lower risk of Parkinson’s altogether
  5. Lends You a Longer Life– a study that accounted for poor lifestyle habits (eating red meat and skipping exercise, for instance), found that those who drank at least one cup of coffee each day lowered their risk of dying from lifestyle-related health problems over the period of a decade

 

5 Reasons why coffee is bad for you

  1. The acidity of coffee is associated with digestive discomfort, indigestion and heart burn
  2. The caffeine in coffee increases your stress hormones.  The stress response elicits cortisol and increases insulin.  Insulin increases inflammation and this makes you feel lousy
  3. Addiction is often an issue with coffee drinkers and makes it really difficult to rely on the body’s natural source of energy
  4. It reduces fertility – according to some research it can prevent the full development of eggs
  5. It may cause cancer– emerging research has found that coffee contains acrylamide- a known carcinogen

There are more research and resources that are available to us that suggest coffee has more benefits rather than negative consequences, and so like most things in life, it is probably best to just drink it in moderation!

THE SUGAR TAX

In my economics lesson today one of the topics we are studying at the moment is how to reduce the effect of demerit goods (a good or service which has greater social costs when it’s consumed than its private costs and tend to be over consumed), and of course your typical demerit goods such as smoking, gambling and sugar came up… But why isn’t there a sugar tax in the UK? It seems easy enough to tax people on their sugary foods to deter them from buying them and surely this benefits everyone?

Well yes it does have a lot of benefits but thats not quite all there is to it...

The taxation would deter people from buying these foods and reduce the risk of conditions such as obesity, type II diabetes, tooth decay, heart disease, and thus also benefiting the NHS as it would reduce the effects of this problems resulting from sugary foods in the UK and so allows the NHS to allocate more of their resources to other health departments.

However it is also important to see the other side of the argument- sugary food is much less expensive than ‘healthier’ foods and so for people on much lower incomes in particular, sugary foods are much more affordable to them. In particular with lower income groups, the sugar tax would take a higher proportion of their income thus making it regressive.

THE SOLUTION

Although both of these arguments are strong arguments and it is something that will be continuously debated, a point most people miss is that a sugar tax isn’t the only solution here….

  1. Something the government could do is subsidise healthier foods (where money is paid by the government to the producer of a good to make them reduce their costs)- this would make healthy foods more available to everyone
  2. Another HUGE problem in todays society is information failure. There is a HUGE information failure in the food market and if this failure were to be counteracted, it would make a large difference to the number of people who have health problems related to sugary foods. For example in your average flavoured yoghurt (silk peach soy yoghurt) there is 15g of sugar!!! Now firstly that figure is not emphasised enough on the packaging of this yoghurt but as well as this it is not a very easily interpreted  figure. 15g of sugar is the equivalent of 4 teaspoons of sugar… 4 teaspoons of sugar in one yoghurt?!?! The average recommended for an adult per day is about 30g for those aged 11 and over… So to put this in perspective you are eating HALF of your recommended intake of sugars for the day in one very small yoghurt!! This information failure needs to be solved and one of the ways I personally think that society would benefit from, is writing the equivalence of the grams of sugar in a food, in teaspoons. This is easily understandable and easy to picture and might help people understand just how much sugar they are eating and lead them to make a healthier choice or to be aware of how much sugar they should aim to eat for the remainder of the day.

Overall, I think that before a sugar tax is considered, we should try to improve other aspects of packaging in sugary foods to counteract the information failure of this industry or subsidise healthier foods and try to make an improvement this way.

Next time you go shopping, think twice about the label!

10 SHOCKING facts about your body!

  1. Your heart can keep beating outside of your body– the heart is one of the very few muscles which is not regulated by the body, but within the heart itself. So as long as the heart has enough ATP to provide energy and exposure to oxygen it will continue beating for a short period after removed from the body2BCD3F0000000578-3215921-image-m-35_1440932445952.jpg
  2. There are mites living inside your eyelashes , that look like this-eyelash_mite.jpg
  3. The average adult has around 10 times more bacteria than human cells living inside their body
  4. There could be more bacteria living in your mouth than there are humans on the planetgetty_rf_photo_of_bacteria_viruses.jpg
  5. There is a disorder called Exploding Head Syndrome where you hear a really loud bang just as you are falling asleep
  6. When you blush, the lining of your stomach does too- blushing happens when a surge of adrenaline caused by anxiety or embarrassment makes capillaries widen all over your body, allowing more blood to flow. It is more obvious in your cheeks and stomach as the capillaries are closer to the surface there
  7. From around 30 years old you will loose around half an inch in height every ten yearsStages-of-height-loss.png
  8. By the age of 60 you loose about half of your taste buds
  9. Babies are born with over 90 more bones than they’ll have as adults- the extras will gradually fuse as they grow older
  10. Every atom in your body is billions of years old- 9.5% of your body is made from hydrogen made 13.7 billion years ago in the Big Bang. Carbon (making up 18.5% of your body) and oxygen (65%) were forged in stars and scattered across the universe when they died.big-bang-780093.jpg

You KNOW YOUR DEAD when you DIE?!

It’s hard to fathom that this might be the case, but recent studies show that a persons consciousness continues to work even after the person has died. Just imagine hearing your own death being announced by medics…

 

How does this happen? 

  • Medically, doctors define death based on when the heart no longer beats which then means the blood supply going to the brain is immediately cut off
  • So the brain stops working almost instantaneously and you loose all your brain stem reflexes 

  • The part of the brain which is responsible for thinking and processing information from the five senses ( the brain’s cerebral cortex) also instantly stops working and flatlines
  • This means that within 2 to 20 seconds no brainwaves will be detected on an electric monitor
  • This sparks a chain reaction of cellular processes that will result in the death of brain cells
  • Brain cells can take hours to die so this can take hours after the heart has stopped

 

However the researchers also found the experience of death can be very different for individual patients… So while I hope that I will be conscious for a bit after I die as it would be fascinating, I guess I will just have to wait and see like the rest of us.

The placebo effect works even when you know you’ve been given a dummy pill?!

In my critical thinking lesson today something we studied was the placebo effect, which I found very interesting and so read up some more on it and here is what I found…

First of all I’m just going to break down what the placebo effect is to those who are unaware… The placebo effect is basically what happens when a person takes a medication that he or she thinks will help, but it actually has no proven therapeutic effect for his or her particular condition. For example if you weren’t feeling very well and went to the doctors the doctor may prescribe you with some medicine. So you take this medicine and take it in good faith that it will make you feel better and you do end up feeling better. But then you find out that the medicine you were taking which ‘made you feel better’ had no biological effect to help your recovery and in fact did not help you at all, suggesting your recovery was heavily dependent on the psychological side of your recovery, as you were unaware of the fact.

So what’s this new research found out? Well, that the placebo effect works even when people know they are taking a dummy drug… Crazy right?  Traditionally it was thought that sugar pill were only effective when their clinical inefficacy  was hidden from the patient.

Researchers at Harvard University in the US and the University of Basel in Switzerland conducted an experiment on 160 volunteers who were asked to put their arm on a heating plate until they could no longer withstand the pain. All were then given placebos, but one third of the group were told they they had received the topical painkiller lidocaine to help with the burn. A second group was warned the cream was only a placebo but also given a 15 minute talk explaining how dummy drugs can help. A control group was told they would have a placebo, but without any additional commentary. The results showed that those who knew about the placebo experienced similar pain relief as those who thought they had been administered with lidocaine. In contrast the control group were left in uncomfortable pain.

What does this mean? As well as being a fascinating piece of science that could definitely be of use in peoples recovery in the future when we learn how to use it most effectively as this is relatively new information, but for now it is being perceived as a breakthrough that could lead to cheap medicines which work by the power of suggestion alone.

LONELINESS…

Looking around my school, I see distinct friendship groups in my year… I also see a few  people on their own,  who just simply enjoy immersing themselves in their own company… Are they lonely?

Have you ever been lonely before?

I’m sure you have at some point in your life before, whether it be while you’re waiting for your train on your own or you have gone away on your own and miss home, but maybe not to the point where you feel as though you are loosing yourself.

That you are drowning in silence.

That you are not important.

DEPRESSION

Recently, a study conducted over a five year period at the University of Chicago found that the presence of loneliness early in the five year span was an excellent predictor for depression later in the five year span. It showed that  loneliness was an even better predictor than the presence of depression itself early in the five year span.  Loneliness may precede depression even more frequently then we think.

SOCIAL ANXIETY

On June 26th, 2015 NPR ran a story about how research suggests lonely people may actually have superior social skills than those who are not lonely. In other words, lonely people are not lonely because they don’t know how to talk to people. Instead, findings suggest they struggle with relationships because they are scared of messing up – they worry about saying the wrong thing in social situations. I see this as suggesting that loneliness and social anxiety may be intertwined, creating a vicious cycle of isolation and fear of isolation.

These are just two examples of what loneliness can lead to, however there are many more such as- an addiction to drugs, alcoholism, hoarding (obsessive- compulsive disorder), Alzheimers disease, suicide and personality disorders.

More awareness needs to be raised for issues such as loneliness and other mental health issues in particular in young adults, where this seems to be most common. People underestimate the effect it can have on a persons life. There is a difference between being alone and feeling alone. Through doing something as simple as asking if someone is okay, making an effort with them or having a chat with them regularly, who knows the difference you could make to their life because sometimes that is all that is needed.

SUPER MALARIA?!?!

I was at my St Johns Ambulance Cadets meeting and we have been studying diseases and one which particularly fascinated me was not just malaria, but ‘super malaria’….

But what’s the difference between malaria and ‘super malaria’?

Well basically it is a dangerous form of the malaria parasite which cannot be killed with the main anit-malaria drugs. It emerged in Cambodia but has spread to other areas of South East Asia such as Thailand.

The team at the Mahidol-Oxford Tropical Medicine Research Unit in Bangkok said there was a real danger of malaria becoming untreatable.

Prof Arjen Dondorp, the head of the malaria unit, told the BBC News website: “We think it is a serious threat.

It frightens me to think that this ‘superbug’ will spread further and most likely to Africa and even more so to think of the thousands of deaths this may have the potential to cause if not treated properly.

It also got me thinking, as I am going to Thailand in October, how I can help prevent this as it seems anti-malaria drugs may not be all that is needed to prevent it…

Here are some other steps yo u should take if you plan on travelling anywhere in South East Asia in the future…

  1. Awareness of risk- visit your GP or local travel clinic before you travel to make sure that you are at a higher risk of getting malaria and specific advice
  2. Bite prevention- use insect repellent, cover your arms and legs and use a mosquito net
  3. Check whether you need to take malaria prevention tablets
  4. Diagnosis- seek immediate medical advice if you have malaria symptoms up to a year after you return from travelling

It’s a race against the clock and we need to eliminate it before malaria becomes untreatable again and we see a lot of deaths. Around 700,000 people a year die from drug-resistant infections, including malaria and if nothing is done, this could increase to millions of people every year by 2050.

You can help reduce this number by doing something as simply as this donating to a charity organisation such as ‘Malaria No More UK’. Many people in these countries are unable to afford to buy mosquito nets and sufficient treatment and by donating to organisation which help provide these things, it can make a huge impact.

https://www.malarianomore.org.uk/donate

You can help make a difference while we find a cure for ‘super malaria’.

 

 

 

Do I have to?

So lately I’ve not been feeling too great and have been down with an ear infection! Annoying right? Well I went to the doctors and I was prescribed with a course of antibiotics for around 5 days, however now (day 3) I am feeling completely better… So why do I have to keep taking this medication? Why can’t I stop taking the antibiotics when I feel better rather than finishing the course?

Many of us know that finishing the course early does not kill all the bacteria and so those resistant bacteria are given the chance to reproduce rapidly and so it will mean that antibiotics will have no effect in the future. However the idea that stopping treatment early encourages antibiotic resistance is not supported by evidence, while taking antibiotics for longer than necessary increases the risk of resistance….

So yes, for common bacterial infections, no evidence exists that stopping antibiotic treatment early increases a patients risk of resistant infection. If patients are being put at unnecessary risk from antibiotic resistance when treatment is given for longer than necessary, then why do we continue to let this happen?

There is not enough evidence to fully back either case…  So what do you think? Should we complete the full course of antibiotics or is it pointless if your feeling better already?

ACID ATTACKS!!!- how to help

The number of acid attacks in London has been growing and growing recently and there were 454 attacks recorded from 2016, greatly contrasting to the 162 attacks in 2012. In the past, the majority of the attacks were related to robberies whereas now it appears that acid is now being used as a substitute for carrying knives, and many of them now linked to gang related crimes.

Carrying corrosive substances now is legal with no restrictions on the volume or strength of them, although. change in legalisation is being considered and in my opinion this should be fast traced to ensure that carrying corrosive substances becomes a criminal offence.

Bystanders who come to the aid of the victim of an acid attack can have an important role in minimising further injury. This is what you should try to do…

  1. Remove the victim from exposure as soon as possible
  2. Wash the victim with as much water as possible (a hose is suggested) on the person as it is vital to remove the chemicals and this should be done as soon as possible to minimise the long term effects of scaring and need for surgical reconstruction.

It’s vital that we do as much as possible to educate people on updated first aid skills, in particular people who live in London or visit frequently where it is more common, as basic knowledge of what to do when something such as an acid attack happens can help a lot. It’s imperative that more vigorous laws are introduced in places where these corrosive acids are sold and on who can buy them in order to minimise the risk of these attacks in the first place. I sincerely hope that we are never put in the situation of being a bystander to a victim of an acid attack but if we are, do hope that you would now be able to help.