Wednesday, 17 August, 2022


High fibre African diet reduces colon cancer risk

American and African volunteers swopping diets for just two weeks had dramatic effects on risk factors for colon cancer. Western diets, high in protein and fat but low in fibre, are thought to raise colon cancer risk compared with African diets high in fibre and low in fat and protein. The study confirmed that a high fibre diet can substantially reduce risk.

Minister laments lack of interest in prevention campaigns

The South African government's recent introduction of two new childhood vaccines has slashed the number of cases of life-threatening pneumonia and rotavirus, yet these successes have been barely acknowledged, says Minister of Health Aaron Motsoaledi. Business Day reports that delivering his budget speech to Parliament, Motsoaledi lamented that public discourse placed too much attention on events in hospitals and clinics. 'Any one negative event that takes place there is almost immediately regarded as the collapse of the health system,' he said.

Right-to-die judgment under siege

[caption id="attachment_4198" align="alignright" width="300"]Stransham-Ford2.jpgRobin Stransham-Ford last week and In better days - Pics courtesy of Netwerk24[/caption]Despite a landmark North Gauteng High Court ruling in favour of a man who wanted his doctors to be granted permission to help him die, the 'right-to-die' remains elusive for South Africans who are terminally ill. Health Minister Aaron Motsoaledi's said giving doctors the right to end a life is 'dangerous' and that the Health Department will now join hands with the Department of Justice and Constitutional Development to appeal the judgment. The South African Medical Association (Sama) has warned that even if the law were to permit medical practitioners to help patients end their lives, the ethical rules of the Health Professions Council of SA (HPCSA) would not allow this and such a doctor would face disciplinary action. Judge Hans Fabricius suggested Parliament should give ‘serious consideration’ to introducing a draft law legalising euthanasia. This MedicalBrief report contains also access to the full judgment.

Heart stopping news for polygamists

[caption id="attachment_4121" align="alignright" width="300"]ZumaPic courtesy of Timeslive
President Jabob Zuma with four of his wives[/caption]Polygamy increases the risk of heart disease by more than fourfold, reveals Saudi Arabian research. The risk and severity of heart disease increased with the number of wives. Dr Amin Daoulah, a cardiologist at the King Faisal Specialist Hospital and Research Centre in Jeddah, Saudi Arabia, whose multicentre observational study was presented at the Asian Pacific Society of Cardiology Congress 2015, said ‘This could be because the need to provide and maintain separate households multiplies the financial burden and emotional expense. Each household must be treated fairly and equally, and it seems likely that the stress of doing that for several spouses and possibly several families of children is considerable.’

In-patient cirrhosis deaths plummet

The largest US sampling to date found 'dramatic improvements' in the survival of patients with cirrhosis and liver failure.

NAFLD promotes coronary artery calcification

Non-alcoholic fatty liver disease (NAFLD) plays a role in the early stages of coronary atherosclerosis and in its more severe form it can also promote the development of coronary artery calcification (CAC).

HCV increases cancer risk 'significantly'

Cancer rates in patients with the hepatitis C virus (HCV) were significantly increased compared to the non-HCV cohort.

50th International Liver Conference, Vienna, Austria

motsoalediSome research highlights from the European Association for the Study of the Liver’s 50th International Liver Conference, including a potential cure for hepatitis B virus infections, with a promising new treatment proving 100% successful in pre-clinical models and new hepatitis C virus treatment guidelines.

HCV combination therapies show promise

A number of new HCV combination therapies show promise.

Potential cure for HBV

Australian scientists have found a potential cure for hepatitis B virus (HBV) infections, with a promising new treatment proving 100% successful in eliminating the infection in pre-clinical models.

New HCV treatment guidelines

The European Association for the Study of the Liver (EASL) has released its latest hepatitis C treatment guidelines.

HBV vaccination must be expanded

The universal infant hepatitis B virus (HBV) vaccination needs further expansion to significantly reduce HBV transmission and liver disease mortality, according to an Imperial College London analysis.

NASH has 50% higher death rate than NAFLD

A population-based cohort of almost a million people in the UK found that the chances of dying from non-alcoholic steatohepatitis (NASH), over a 14-year period, was approximately 50% higher than for those with non-alcoholic fatty liver disease (NAFLD).

Fat Blocker moves to silence fact checker

HarrisDr Harris Steinman, a medical doctor and consumer activist who runs a South African website exposing misleading claims about health products, has been forced to move his site offshore after sports supplement company USN demanded his internet service provider (ISP) take down his  CAMcheck site because it was ‘unlawful’. Steinman has long been a thorn in the flesh of complementary and alternative medicines (CAM) manufacturers because of his success in using the Advertising Standards Authority to remove or change misleading advertising. IT specialist Kevin Charleston says that this is the latest tactic by CAM manufacturers to silence critics. Some also were using intimidatory and expensive suits (so called SLAPP suits) to intimidate.

The world’s men beat a path to Tygerberg’s door

transplantSU The doctors at Tygerbeg Hospital who carried out the first successful p enis transplant on a patient who had a botched traditional circumcision, have been inundated with requests from men around the world who want to have the operation. Stellenbosch University doctors said the procedure could eventually be extended to men who have lost the organ from p enile cancer. In other p enile research at King's College London, researchers reviewed studies of p enis measurements for more than 15,000 men, the largest collection yet, to come up with a graph that can be shown to men who wonder, or obsess over, how theirs measure up.

Malpractice lawyers, HPCSA, hospital CEOs and private healthcare – all under fire


Health Minister Dr Aaron Motsoaledi has in short order sharply criticised medical malpractice lawyers, instituted an inquiry into the Health Professions Councils of SA (HPCSA), another into state hospital CEOs, and been highly critical of specialists and private hospital groups: * State hospital CEOs are in cahoots with malpractice lawyers, says Motsoaledi, ‘deliberately failing to apply norms and standards’, hoping something would go wrong. They then colluded with state attorneys to deliberately ‘mismanage ... so that we lose the case’. The SA Medical Association notes ‘several cases where nurses and admin clerks are being investigated for selling patient files to lawyers specialising in malpractice’. * Motsoaledi has appointed a six-person panel to investigate claims of poor governance and mismanagement at the HPCSA. * Motsoaledi has blamed ‘profit-maximising specialists and hospitals’ for the high cost of medical care in the DOH submission to the Competition Commission inquiry into private healtcare.

Summary report drawn from City Press, Polity, HPCSA, Politicsweb, Moneyweb and DOH material

Campaign against 'too much medicine'

Summary drawn from Business Day, Citizen, IOL and Health ministry materials As part of a campaign against 'too much medicine' The British Medical Journal has published reviews that question the value of screening for breast cancer in women and aneurysm in men – asking whether the harm of 'over-diagnosis' outweighs the benefits of early detection and treatment of real cases. In similar vein,  in a recent JAMA Internal Medicine review of 36 studies on a range of medical interventions — from cancer screening tests to medications and surgeries — researchers discovered that, overwhelmingly, patients overestimated the benefits and underestimated the harms.

Global food giants revisit use of antibiotics

Global restaurant chain McDonald's is to reduce antibiotic use in its chicken products. It will remove antibiotics that can have an impact on human health, but keep those necessary for poultry welfare. Also, its dairy products would be derived from cows that have not been treated with the artificial growth hormone, rbST.

‘National crisis’ in obs/gynae, neurosurgery, neonatology and orthopaedics

Aaron Summary drawn from Business Day, Citizen, IOL and Health ministry materials Dr Aaron Motsoaledi has accused personal injury lawyers of creating a ‘national crisis’ similar to that which collapsed of the Australian health system 15 years ago, with doctors scared of certain specialist areas. The government faces contingent liabilities of R25bn for medical malpractice lawsuits, while private sector doctors are battling to keep up with steeply rising premiums for professional indemnity cover. Some medical specialities are ‘continually, persistently, and mercilessly being targeted for litigation’, said Motsoaledi, noting that he would like to see some public hospitals CEOs arrested for being part of syndicates that were looting funds.

Expert committee redefines and renames ME/CFS

The Institute of Medicine has delivered a report not only supporting the long disputed diagnosis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), but declaring the need to find a ‘less demeaning’ name, have designated it as Systemic Exertion Intolerance Disease (SEID). The move coincides with researchers at Columbia University identifying distinct immune changes in patients diagnosed with SEID. Some physicians, however, appear to remain sceptical. As one commented in The New York Times, 'Chronic fatigue and fibromyalgia — two wastebasket diagnoses in search of a pathology.’ Summary drawn from Institute of Medicine and Columbia University material, Clinicians Guide, The New York Times, Science Advances, and the AAFP.

'Flawed research' accusations

Patients in the very early stages of dementia could miss out on a potentially effective treatment after misleading research was published last year, say medical experts. The researchers, who claimed that B vitamins were 'sadly not going to prevent Alzheimer's disease; have been strongly criticised by experts in dementia, nutrition and biochemistry from the universities of Oxford, Cape Town, London and Oslo, as well as Tufts University in Boston. Summary drawn from the American Journal of Clinical Nutrition

Studies shoot down 'inflated' statin claims

Report from Science Newsline, Expert Review of Clinical Pharmacology and Movement Disorders While statins produce a dramatic reduction in cholesterol levels they have failed to substantially improve cardiovascular outcomes, according to a critique in the Expert Review of Clinical Pharmacology. The authors claim that many positive studies about statins not only 'neglected to account for the numerous serious adverse side effects of the drugs', but supporters of statins have used 'statistical deception" to make inflated claims about their effectiveness. Meanwhile, a National Institute of Environmental Health Sciences study cast doubts on reports that statins may protect against Parkinson's disease.

New guidelines from CDC and NHS on patient deaths

Report from LA Times, Reuters, WISH, CDC, and NHS materials The role of hospital medical devices in patient deaths is the focus of new protocols from the US Centres for Disease Control (CDC) and Britain's National Health Service (NHS). The CDC's non-mandatory guidelines come upon the heels of two deaths when nearly 180 patients were exposed to bacteria from contaminated endoscopes. The CDC has been investigating duodenoscope-transmitted infections since 2013. The NHS has issued a patient safety alert on non-invasive ventilators (NIVs) after four deaths. Unlike life support ventilators, NIVs can lack the features to warn staff of delivery problems, such as disconnection and loss of oxygen supply.

Sugar-coating the research pill

A four-part British Medical Journal investigative report claims to expose 'extensive links – going much deeper than previously known – between public health scientists and the sugar industry. Although the investigation was conducted in the UK, it is bound to raise questions in other countries, as the findings implicate international food and drinks manufacturers.

Health dangers of smoking far worse than thought

A massive study, drawing on the data of nearly a million people over 10 years, adds at least five diseases and 60,000 deaths a year to the toll taken by tobacco in the US. Previously, smoking was already blamed for nearly half a million US deaths from 21 diseases, including 12 types of cancer. * Smokers were about twice as likely to die from infections, kidney disease, respiratory ailments not previously linked to tobacco, and hypertensive heart disease. * Smokers were six times more likely to die from a rare illness caused by insufficient blood flow to the intestines. Other recent research: * A major British-Canadian study shows new evidence that long-term smoking could cause thinning of the brain's cortex. * Smoking impairs the response to drugs used to treat inflammatory arthritis affecting the lower back, found a Swiss study. * A University of California study found that children exposed to tobacco smoke while in the womb are predisposed to developing diabetes as adults. Summary drawn from New England Journal of Medicine, The New York Times, Science Daily, Annals of the Rheumatic Diseases, and the Journal of Developmental Origins of Health and Disease

Top herbal products 'fraudulent and potentially dangerous'

New York State Attorney-General's Office  investigation of the herbal products sold by four prominent national retailers found that four out of five products tested did not include any of the herbs listed on their labels. Worse, hidden ingredients and contaminants could be dangerous to people with allergies to those substances.  Meanwhile, South African health and beauty retailer Clicks has said it would continue to sell US-based GNC's products despite the NYC finding that these were 'fraudulent and potentially dangerous'. GNC has rejected the AG's findings were based on 'inappropriate' DNA bar-coding tests.

CPR guidelines mistaken on depth of compressions

Contrary to popular belief and American Heart Association guidelines, chest compressions deeper than 55mm result in decreased survival, possibly because of collateral damage to other internal organs, according to a review of research by University of Texas emergency medicine physicians. About half of responders were also giving compressions faster than the 100 to 120 per minute that are optimal for survival, the findings, from two independent studies, showed.

'Significant' increase in dementia risk

Summary report drawn from JAMA Internal Medicine and The Guardian A US study has found that over-the-counter sleeping aids and hay fever treatments can increase the risk of Alzheimer's disease and other forms of dementia significantly over several years. The sleeping medication Nytol and anti-allergy pills Benadryl and Piriton all belong to a class of drug having 'anticholinergic. blocking effects on the nervous system. Other drugs on the risk list include older 'tricyclic' antidepressants such as doxepin, and the bladder control treatment Ditropan (oxybutynin). Many of these medicines are taken by vulnerable older people, according to the scientists, who say their findings have public health implications.

New insights into an old problem

Summary report drawn from MedicineNet, Time, Reuters Health, Journal of Hepatology, Stroke, Advances in Nutrition and JAMA Pediatrics The dangerous effects of alcohol have been studied for centuries, but research continues to throw up interesting new findings: * It has been assumed cirrhosis is a function of the volume of alcohol consumed irrespective of drinking patterns. Investigators have now established that alcohol drinking pattern has a significant influence. * Too much alcohol in middle age can increase stroke risk as much as high blood pressure or diabetes. Midlife heavy drinkers were likely to have a stroke five years earlier in life, irrespective of genetic and lifestyle factors, a study found. * For years, research has suggested that mixing alcohol and heavily-caffeinated energy drinks could have negative health effects. Research as now found that combining the two seems to make you want to drink more, as well as mask signs of inebriation.

Proclamation led to 'untenable and unintended’ situation

Summary report drawn from The Times, Mail&Guardian, News24, Business Day and the Constitutional Court judgment The South African Constitutional Court yesterday handed government’ legal advisers a stinging rebuke, describing President Jacob Zuma’s signing of a proclamation that forces healthcare workers to obtain government permission to work in their preferred location as ‘irrational and invalid’. The Court nullified sections 36-40 of the National Health Care Act but the legislation remains on the table.

Summary report drawn from Science Daily, International Journal of Epidemiology, Medical News, The New York Times, and CBS News Screening for disease has long been a key component of modern healthcare. Now Stanford School of Medicine researchers evaluating 39 screening tests for 19 major diseases from 48 randomised controlled trials and 9 meta-analyses have shown that few screening tests for have brought documented reductions in disease-specific mortality. Similarly, it is being argued that the annual medical check-up is of little value and should be abandoned. This has brought a strong response from family physicians.

From soil micro-organism to pharmaceutical gold

Smartphone A new antibiotic – the first in nearly 30 years – has been discovered by scientists who claim it appears to be as good, or better, than many existing drugs ,with the potential to work against a broad range of fatal infections such as pneumonia and tuberculosis. Successful in animal tests, the antibiotc is born from a new way to tap the powers of soil microorganisms, Because resistance can evolve quickly, the high costs of drug development aren't seen as having long-term value, and fewer new antibiotics are reaching the market. However, he prototype drug, called teixobactin, works against harmful bacteria in a unique way that is highly unlikely to lead to drug-resistance. Report drawn from The Independent, Smithsonian Mag, Nature, Business Day and The Guardian  

Deadly virus outbreaks are stretching medical services

Deadly virus outbreaks are testing the ability of medical services around the globe. BBC News reports that health ministers from 11 West African countries...

Stellenbosch University calls for cease of 'eligibility debate'

Stellenbosch University researchers have called on the scientific and activist communities to ‘cease debating who is “eligible” or not for HIV treatment” in favour...

Locations and populations targeted in war against HIV/Aids

The 20th Annual Aids Conference held last week in Melbourne, Australia drew the likes of former US president Bill Clinton, singer Bob Geldorf and...

The fragile state of South Africa’s health system

Mpumalanga’s public hospitals have come under fire as being possibly the most haphazard and hazardous in SA. The Times reports that authorities have admitted...

TB biggest killer in SA mines

For every worker who dies each year as a result of an accident on a SA mine, nine more die of tuberculosis (TB). The...

Data review shows more MERS deaths than originally reported

The MERS virus has caused nearly 50% more deaths in Saudi Arabia than has been officially reported, a review of medical data by Saudi...

Govt announces ambitious programme to fight TB

An ambitious programme to fight tuberculosis could see every prisoner, mine worker and school child in the country screened for the killer disease in...

Global obesity rates will ‘crush public health systems’

The number of people in the world who are obese or overweight has topped 2.1bn, up from 875m in 1980. And, BBC News reports,...