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If you keep nodding off while trying to read this article you probably won’t know that insomnia is a highly prevalent condition, with up to a third of all adults thought to suffer from insomnia at some time. Insomnia is debilitating and has been noted to have associations with a variety of psychiatric conditions.

Melatonin, an endogenous sleep regulating hormone, has long been mooted as a potential therapy for this condition. Endogenous melatonin production is known to decrease as a person ages, therefore it has been hypothesised that treatment with this hormone may be efficacious in treating insomnia in the elderly. However results from studies have often proved contentious, with a lack of consistency in the results seen in differing age groups exposed to melatonin therapy.

Results from a recently published randomized controlled trial in BMC Medicine have now shed new light on this controversial subject. The researchers examined the use of prolonged release melatonin (PRM) in sufferers of primary insomnia across a wide range of ages. Their results showed that PRM is particularly effective and well tolerated in patients aged 65 years and over, with the treatment response increasing and being sustained over a 6 month period.


bookmark Melatonin Effective for Treating Insomnia (in the elderly)

There are currently over one million people in the UK suffering with severe and complex obesity (defined by NICE as a BMI of over 40 or between 35 and 40 if suffering from other significant disease) and the management of this obesity epidemic is currently costing the NHS around £4.2 billion, with indirect healthcare and societal costs estimated at around £16 billion; figures which have been predicted to more than double by 2050.

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bookmark Obesity Surgical Experts Promote Bariatric Surgery

London Cardiology Expert shows a 26% reduction in hospitalisation and death from heart failure.

Procoralan® (ivabradine), a drug costing less than £10 a week has been proven to improve survival of patients with heart failure according to new research presented at the European Society of Cardiology (ESC) meeting.  The new research (SHIfT sudy*) showed that the drug, ivabradine, significantly reduced the risk of death from heart failure by 26%, and the risk of hospitalisation was also significantly reduced by 26%. The benefits were seen even though the heart failure patients were already taking currently recommended treatments.
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bookmark New Heart Drug Saves Lives

NICE have issued new guidance highlighting the importance of measuring high blood pressure in pregnant women. This follows news earlier in the year that compared the safety of child birth in different countries and pointed out that it was more dangerous to give birth in the United States than it was in Beirut, mostly due to the dangers of undetected and untreated high blood pressure (hypertension) and pre-eclampsia. Continue Reading »


bookmark Importance of Screening in Pregnancy for Pre-Eclampsia and Proteinuria

… Only if it is the right side of the ‘Directive’

UK Herbal Forum has warned that the European Union may find its pharmacy store shelves filled with illegal herbal products if companies don’t register their products under the Traditional Herbal Products Medicinal Directive (THMPD).

The Directive become law in 2004, giving herbal products making medicinal claims across the EU bloc seven years to register their products by submitting a supporting dossier. With that deadline of April 30, 2011 less than a year away, concern is growing that a swathe of products that may be perfectly legal under national laws will find themselves on the wrong side of the THMPD.

The UK has been the most active member state by far in terms of product registrations, with the UK Medicines and Healthcare products Regulatory Agency (MHRA) approving 69 products so far out of 152 applications received. None have as yet been rejected. The 69 approvals have featured 27 different herbs from valerian to sage, black cohosh, St John’s Wort and Echinacea. Thirty one applications have been lodged so far in 2010. A list of the latest registrations can be found here.

Registrations are known to have occurred in Germany, the Netherlands and Slovenia but at low numbers. UK Herbal Forum members include the British Herbal Medicine Association, the UK Council for Responsible Nutrition, the European Herbal Practitioners Association, the UK Health Food Manufacturers Association and the Proprietary Association of Great Britain.


bookmark Herbs - Supplements or Medicine?

The FDA have approved further trials following the publication of positive data demonstrating beneficial affect of MDMA in treating veterans with post traumatic stress. Continue Reading »


bookmark MDMA (Ecstasy) to treat Traumatic Stress

Comment on one of our posts on Cyberknife Radiosurgery

I am delighted that the NHS is beginning to embrace the Cyberknife radiosurgery system.

What is concerning me is the situation which has arisen, whereby some Trusts are willing to refer NHS patients for assessment at Cyberknife Centre and others flatly refusing. This is as bad, if not, worse, than the drug postcode lottery and I now find myself being again, patronised and dismissed as a busy body by MPs, journalists and health professionals. There needs to be some kind of uniformity regarding this, particularly because, by the end of 2011, there will be at least three Cyberknife systems in the NHS.

I intend to continue my quest for fairness re this issue. I find it obscene and unacceptable for non-medical personnel in the NHS to be making decisions on matters they really do not know enough about. Cyberknife is here to stay, thank goodness and I am sure it will go from strength to strength!


bookmark Cyberknife is here to stay

Professor Sir Ian Gilmore, president of the Royal College of Physicians said: ‘The plans set out in the White Paper represent a welcome shift towards a greater focus on measuring health services on grounds of quality and outcomes rather than on activity and process targets. We are particularly pleased that the crucial role of national clinical audit will be strengthened and that GPs will again be able to refer patients to individual hospital specialists in line with the patient’s wishes”.

GP’s have always been known to be responsible as the ‘gate-keepers’ to the NHS with reference to their role to refer patients appropriately. The White Paper fundamentally describes how new policy will attach ‘accountability’ to that responsibility, and involve patients in the decision.

The new guidelines describe how more information on hospital performance will be available to inform choice, and clearly patients will also want more information on individual consultants and the latest treatment options. Nick Clegg says that the plan is for: “Patients to have more control”.

The Biggest Difference is Patient Information

The Chief Executive of The King’s Fund, Professor Chris Ham commented: ‘Today’s White Paper represents one of the biggest shake ups of the health system since the NHS was established. The ambitions it sets out for a more patient-focused, clinically-led NHS are the right ones”.


bookmark Patients have Power to Choose Hospital Consultant

Two papers presented at an international obesity conference yesterday have found that a range of the most popular weight loss supplements available on the market are no more effective than a placebo.

According to the author of one of the papers, the science backing a variety of weight loss supplements is lacking. “The market for these is huge, but unlike for regulated drugs, effectiveness does not have to be proven for these to be sold,” said Dr Thomas Ellrott, head of the Institute for Nutrition and Psychology at the University of Göttingen Medical School, Germany. “Few of these supplements have been submitted to clinical trials and the landscape of products is always changing, so we need to put them through rigorous scientific evaluation to determine whether they have any benefit,” he said.

However, the manufacturers of weight management dietary supplement products who were contacted by NutraIngredients.com still stressed the ‘robustness’ of the science backing the efficacy of their products.
Placebo-controlled Weight Loss

Dr Ellrott’s study was a randomized, placebo controlled, partly blinded eight-week trial, where 189 overweight or obese individuals were given either a weight loss supplement in doses recommended by the manufacturers, or a placebo. The nine supplement products tested were purchased at pharmacies in Germany. Labelled active ingredients were: Polyglucosamide, cabbage powder, Konjak extract, sodiumalginate-complex, bean concentrate, selected plant extracts, L-Carnitine, fibre formulation and Guarana seed powder.
First Systematic review of all scientific literature

The second study, led by Dr. Igho Onakpoya of Peninsula Medical School at the Universities of Exeter and Plymouth, UK, claims to be “the first systematic review of all existing systematic reviews of clinical trials on weight loss supplements.”
Literature searches were conducted in five electronic databases to identify all relevant articles on nine popular slimming supplements. These include: chromium picolinate, Ephedra, bitter orange, conjugated linoleic acid (CLA), calcium, guar gum,


bookmark Weight loss supplements simply don’t work

The Kings Fund sent us a list of 10 challenging questions they’d like to ask the Government concerning its new NHS White Paper.  The first seems particularly pertinent.

The coalition government has signalled its intention to put patients at the centre of the NHS and to start an information revolution by publishing more information about quality and outcomes.  While patients want to be more involved in decisions about their care and to be supported to make informed choices, professionals are often too busy to do this, do not see this as their role, and believe that patients want them to make decisions for them.  How will professionals be motivated and supported to put patients first and involve patients more in decisions?  Will patients and professionals be able to make use of the information to drive improvements in care?


bookmark How will patients be supported to take greater responsibility and to exercise informed choices?

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