Category Archives: Medical

Britain, Health, Medical, Research, Science

A breakthrough test to tell if you really need antibiotics…

CRP TEST

A simple three-minute blood test could tell doctor’s whether a patient needs antibiotics.

Not only could this help patients avoid suffering nasty side-effects from taking unnecessary drugs, but it could also tackle one of the greatest threats to modern health – antibiotic resistance. The test tells a doctor whether the patient is suffering from a viral or bacterial infection – that way, they will know whether or not to prescribe antibiotic medication.

Antibiotics are only effective against bacteria – they do not kill viruses. Currently, the type of infection can only be confirmed with a blood test which must be analysed in a laboratory, a process that can take two to three days.

GPs say they often give antibiotics as a full-safe measure, and that patients pressure them for the pills. According to Public Health England (formerly the Health Protection Agency), if patients ask their doctor for an antibiotic, the vast majority will get one.

Over-prescribing of antibiotics has consequences both for the patient and the population. As well as causing side-effects, over-use can lead to bacteria becoming resistant, making antibiotics less effective at fighting infections. The Government’s chief medical officer has described this as ‘one of the greatest threats to modern health.’

Over the past five years alone, the number of antibiotic prescriptions has risen by 10 per cent to 41 million prescriptions at a cost of £170 million to the NHS. A third of all Britons have taken them in the past 12-months.

A simple finger-stick test could solve this ‘catastrophic threat’. The test – which involves taking a drop of blood from the finger – can tell doctors within three minutes whether an illness is caused by a bacterial infection which requires antibiotics, or a virus, which does not.

It measures a substance called C-Reactive Protein (CRP) in the blood. The amount of this protein increases when the body is fighting a bacterial infection, but not when it is fighting a virus, which triggers a different immune response.

So a doctor would know that if the CRP level was shown to be low, antibiotics would not be required.

Studies show that providing ‘proof’ that they are unnecessary to patients who demand antibiotics can significantly reduce the number of prescriptions.

One EU-funded study, presented at the World Association of Family Doctors conference in 2010, looked at how respiratory infections which are generally caused by viruses were treated by 600 GPs in six different countries. It found that antibiotic prescriptions fell by 25 per cent when doctors used the CRP test.

British scientists say the test could be a useful tool for significantly reducing antibiotic prescriptions.

A senior clinical research fellow at Cardiff University who specialises in antibiotic resistance in primary care, said:

… Unfortunately, it is very difficult to accurately determine whether an infection is viral or bacterial.

… Markers such as CRP have evolved to help where there is lingering uncertainty after a clinical assessment or where the patient has strong beliefs that antibiotics are needed.

… (However, not everyone needs the test) … Patients who appear very unwell should be treated with antibiotics or admitted to hospital without the test because they could develop complications.

… But for those patients where there is doubt, or where the GP feels antibiotics are not needed but the patient is putting pressure on to prescribe them, the test can be helpful.

The test is currently only available in laboratories in the UK (it can be carried out privately for around £50) because the NHS does not yet fund it in GP practices. The machine to analyse the test would initially cost £1,000 and then £3 per test.

A spokesman for the Royal Pharmaceutical Society says it is likely to be some time before the test is routinely available on the NHS.

… CRP testing would be a natural extension to the clinical services we offer but it will be two or three years before there is enough evidence for it to be made widely available.

Other concerns about the test are that the results are not always clear – levels of CRP also increase as a result of inflammation caused by other conditions such as rheumatoid arthritis as well as infections.

The test is deemed to be a guide and does not categorically imply that a patient has a bacterial infection if the results are synonymous with having an infection. It gives the doctor a number that has to be interpreted in light of the other symptoms and the patient’s overall risk profile.

For example, a doctor is more likely to treat an elderly person with diabetes with antibiotics than a young healthy person, as the elderly person is more likely to develop complications.

Clinical experts say the best way to reduce antibiotic prescriptions is to educate doctors and patients about common complaints and when antibiotics are necessary.

The Royal Pharmaceutical Society warns that to see this test as the panacea would be an extremely dangerous idea. The Society says it needs to work hard to educate patients about when it is appropriate to take antibiotics and by making sure they take them correctly as prescribed by finishing the course.

Public Health England adds:

… CRP may be useful in a small range of infections provided the test is robustly quality controlled.

… But nothing can replace taking a detailed patient history and thorough examination.

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Medical, Psychology, Research, Science, United States

Different types of happiness and the effects on our genes…

GENE-EXPRESSION PROFILES

Research has found that people who derive their happiness from helping others have strong antibody genes, while people who get their kicks from self-gratification can suffer from low antiviral and antibody expression. The study by UCLA, a public research University in Los Angeles, California, is the first of its kind to examine how positive psychology impacts human gene expression.

People deemed ‘do-gooders’ have high levels of ‘eudaimonic’ well-being. Researchers say they derive their happiness from a deep sense of purpose and meaning in life and found favourable gene patterns and expression profiles in their immune cells. Those studied from this happiness group had low levels of inflammatory gene expression and strong antibody and antiviral genes.

The findings by UCLA, first published in the journal Proceedings of the National Academy of Sciences, also conclude that individuals who have high levels of ‘hedonic well-being’, i.e. the type of happiness that comes from consuming goods and self-gratification, showed the opposite. This group of people showed a high propensity towards inflammation and weak antibody and antiviral genes.

The research, led by Steven Cole, a UCLA professor of medicine and Barbara Fredrickson of the University of North Carolina, has taken more than a decade to complete.

The scientists have examined how the human genome responds to fear, stress, misery and other negative mental states. Their focus was on how human genes might respond to aspects of positive psychology in this study. They studied the biological implications of hedonic and eudaimonic well-being through some 21,000 genes.

Previous research found immune cells shifting in baseline gene expression during times of stress, fear and uncertainty. The shift is generally characterised by an increased expression of genes involved in inflammation and much less so of those involved in antiviral and antibody functions.

Professor Cole believes the response probably evolved to help human immune systems cope with the changing nature of microbial threats associated with changing social and environmental conditions at the time. Those threats include bacterial infection from wounds produced by fighting and the increased risk of viral infections as people lived closer together and became more sociable.

Professor Cole said:

… In contemporary society and our very different environment, chronic activation by social or symbolic threats can promote inflammation and cause cardiovascular, neurodegenerative and other diseases and can impair resistance to viral infections.

Researches from the present study drew blood samples from 80 healthy adults who were assessed for hedonic and eudaimonic well-being, as well as negative psychological traits and behavioural factors.

Professor Cole’s team used the gene-expression profile to map the potentially distinct biological effects of hedonic and eudaimonic well-being.

The study found people with eudaimonic well-being showed favourable gene-expression profiles in their immune cells and those with hedonic well-being showed an adverse gene-expression profile.

Interestingly, though, Professor Cole also said:

… People with high levels of hedonic well-being didn’t feel any worse than those with high levels of eudaimonic well-being.

… Both seemed to have the same high levels of positive emotion. However, their genomes were responding very differently even though their emotional states were similarly positive.

… What this study tells us is that doing good and feeling good have very different effects on the human genome, even though they generate similar levels of positive emotion.

… Apparently, the human genome is much more sensitive to different ways of achieving happiness than are conscious minds.

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Health, Medical, Research, Science

Electronic devices in children’s bedrooms should be banned….

… Concentration and behaviour were affected when children were allowed to have TVs or computers in their bedrooms

Scientists say that TVs and computers for children should be banned from their bedrooms. Children who watch TV in the bedroom are less likely to exercise and be tired at bedtime – with researchers insisting that getting a good night’s sleep is particularly important for pre-teens.

Scientists have warned that electronic devices can disturb sleep, leading to memory problems and poorer marks in school.

Researchers from Finland asked 353 children aged 10 to 11 about their TV and computer use and their sleeping habits and quizzed them again 18 months later.

The more a child played on the computer or watched the TV, the later they went to bed. They also slept less on school nights.

Findings reported in the journal BMC Public Health says that having a TV or computer in the bedroom appeared to be particularly disruptive for boys.

The Finnish researchers, based at the University of Helsinki, said that children who play a lot on computers may exercise far less and so be less tired at bedtime.

Hormonal changes, particularly during puberty, brought on by the light of the screens could also make it more difficult to get to sleep.

Researcher Teija Nuutinen, of the University of Helsinki, said that electronic devices should be kept out of children’s bedrooms, and added:

… Children need extra sleep as they go through puberty but our study finds that TV and computer use affect the sleep of children. 

… This is especially true during the week and may be impacting their school work as well as their development. 

… Media viewing habits should be considered for children who are tired and struggling to concentrate, or who have behaviour problems caused by lack of sleep.

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