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BBC Radio 4 Inside Health

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Addiction services; Schizophrenia; Hearts and cancer

Inside Health reveals the poor state of addiction services in England with heroin and morphine related deaths the highest on record. Professor Colin Drummond raises concerns about a split in care between the NHS and Local Authorities since the 2012 Health and Social Care Act. And personal testimony is heard from Alison Bedford Russell whose son George died of a heroin overdose last year. The Care Quality Commission, who is responsible for inspections, has found that 2/3 residential drug...

Duration: 00:27:57

Breast density; Health education; Switching outcomes

Breast Density - the major risk factor for breast cancer that you may have never heard of. Health Education - a long term approach to changing attitudes to illness by encouraging children to be less dependent on doctors and pills. Switching Outcomes - one reason why so few clinical trials result in real changes in practice that benefit patients.

Duration: 00:27:54

Antibiotics, Lung Cancer, Dying of a Broken Heart, Gender Bias

Margaret McCartney unpicks recent headlines suggesting its okay not to finish your antibiotics; Lung Cancer screening in the high risk; Can you die a broken heart? Evidence suggests this is a real condition called Takotsubo syndrome and is much more common than previously thought. And gender bias in trials.

Duration: 00:27:51

PPIs, Aspirin and cancer, Radiotherapy and smoking

There are growing concerns about the widespread use of PPIs, the acid suppressing family of drugs used to treat indigestion and the most prescribed in the world. They are recommended to be used for weeks in typical cases of heartburn, but most people including Mark, take them for months or years. But one reason why PPIs are being used so widely is to protect the lining of the gut from aspirin and combining these two drugs may also have benefits against cancer. Mark hears preliminary...

Duration: 00:27:58

Hepatitis B vaccine, Sheds, Obesity Paradox, Taking part in clinical trials

The Hepatitis B vaccine has been added to the childhood national programme joining the 5 vaccines already given to all young babies at 8, 12 and 16 weeks. Andrew Pollard, Professor of Paediatric Infection & Immunity at the University of Oxford, and Chair of the Joint Committee on Vaccination and Immunisation, explains why. Margaret McCartney and Mark Porter visit men in north London looking for the physical and mental benefits of community sheds. The obesity paradox - can being overweight...

Duration: 00:27:58

Robo-docs, using AI to diagnose; Pancreatic cancer; Statins and muscle aches

Are we on the cusp of a new era where computers rather than doctors will be doing the diagnosing. Ali Parsa, founder of Babylon Health, believes we are and is developing an online tool using artificial intelligence that diagnoses quicker and more accurately than a doctor. He debates the issues with resident sceptic Dr Margaret McCartney. Mark Porter visits the world's first national tissue bank for pancreatic cancer, set up to aid research into a disease that has seen no outcome...

Duration: 00:27:59

High costs of cheap medicines, Can a simple blood test help identify cancer, undescended testes, Aspirin

Price rises of everyday medicines due to some manufacturers utilising monopolies; Can a simple routine blood test help identify cancer; A definitive guide on undescended testes with evidence for the best time to intervene if a baby boy's testes do not drop and the downsides of delay; Aspirin and the risk of stomach bleeds in the elderly.

Duration: 00:27:56

Cholesterol-lowering drug, Defibrillators, Post-traumatic stress disorder and heart disease, Lack of drugs in pregnancy

Statins have dominated the cholesterol-lowering field for some years but last week the results of an international trial of Evolocumab, one a new breed of medicines for reducing cholesterol, was hailed as a breakthrough. Professor Peter Sever, one of the leaders of the trial, explains how Evolocumab differs from statins and Dr Margaret McCartney takes a look at the trial. You may have noticed them in work places, gyms, and other public spaces but do you know how and when to use a...

Duration: 00:27:55

Bisphosphonates, IBS and diet, CRP test for infection, Randomisation

Clarification of new evidence that Bisphosphonates for osteoporosis may actually weaken bones if people are left on them for too long ; Dietary change using FODMAPS to treat Irritable bowel syndrome when medicines have not worked; CRP testing for chest infections to identify which need antibiotics; And Mark eats humble pie for getting clinical terminology mixed up.

Duration: 00:27:52

Opt-out organ donation; your body after death; what time of day to take blood pressure medication

More than 6500 people are currently on the national transplant waiting list, hoping for an organ to be donated which might save their lives. Many of them will wait for years and, sadly, hundreds will die before a suitable organ becomes available. The low supply of organs remains the main restriction on performing lifesaving transplant surgery. The British Medical Association believes that moving to an opt-out donation system - where people who die without expressing whether or not they...

Duration: 00:27:46

Smoking in pregnancy; Lifestyle targets; Thyroid cancer; Flossing

New moves to test pregnant women for smoking by measuring carbon monoxide on their breath. How helpful are lifestyle targets like 10 portions of fruit and veg or 10, 000 steps a day? The incidence of thyroid cancer has tripled in 40 years, but many of the tumours picked up are on scans for something else and may never have caused harm. Mark Porter debates the issues. Plus this week's uncertainty question for Margaret McCartney and Carl Heneghan, to floss or not to floss?

Duration: 00:27:53

Vitamin D, Air Ambulance blood trial, Phantom limb pain, Sitting-rising test

Vitamin D , the sunshine vitamin, has been in the news again with claims that supplements could help ward off coughs , colds and flu. Dr Margaret McCartney takes a look at the study that generated the headlines. Whether or not a severely injured person will receive blood products at the scene of an accident depends on which air ambulance service they are attended by: some air ambulances replace lost blood with red blood cells, but others replace only with saline solution. Evidence from...

Duration: 00:27:44

NHS Special: What needs to give?

A special debate on the current state of the NHS. Recorded in front of an audience at the BBC Radio Theatre London. The last few months have seen the service creaking under unprecedented demand, and there is likely to be worse to come. Something needs to give. Is it simply a matter of more resources, or do we also need to change our expectations of what the NHS provides? Is rationalisation and rationing the way forward? Dr Mark Porter discusses the issues with a panel including Clare Marx,...

Duration: 00:56:56

Over-the-counter prescriptions, Virtual reality in rehabilitation, Sore throats and antibiotics

Prescriptions for over-the-counter items cost the NHS millions each year; in 2015 paracetamol prescriptions alone cost £87.6 million. Mark talks to Paula Cowen, medical director at Wirral CCG, one of a growing number of Clinical Commissioning Groups that are asking GPs to restrict prescribing of these items, and to Andrew Green, a GP and the prescribing policy lead at the BMA, who has reservations. Virtual Reality is being harnessed to help people recover from serious brain injury...

Duration: 00:28:02

Why hernias, hands and varicose veins might not be treated on the NHS

Hernias, hands and varicose veins might not be treated on the NHS as such interventions are now on the 'not normally funded' list. This list is where local commissioners show what they are not prepared to pay for, unless circumstances are exceptional. Such prioritising is also known as rationing. Dr Mark Porter investigates if this new layer of bureaucracy is a cost effective use of resources or just delaying inevitable operations with the possible risk of creating emergencies that could...

Duration: 00:27:59

Preventable deaths, Poo bank, Waterbirths

Are preventable deaths in hospitals a good measure of the quality of care being offered to patients? It's estimated that there are 12,000 deaths a year in hospitals which could have been avoided, but what does that mean and should we be worried that that number could rise with the NHS under pressure? Mark Porter visits a 'poo bank' in Portsmouth where donated faecal matter is being frozen and stored for later use in patients with Clostridium difficile or C. diff. And midwife Mervi Jokinen...

Duration: 00:27:49

NHS under pressure, Breast cancer prevention, Lactose intolerance

Do funding requests hinder surgery on the NHS? GP referrals to specialists for common complaints are checked by a panel to make sure they're appropriate, but can the admin for funding requests be more costly and time consuming than the operation itself? Mark Porter meets an eye specialist in Reading who argues that it can. Plus a new genetic test that has been developed to identify women at risk of breast cancer more accurately. And lactose intolerance: there's a burgeoning number of...

Duration: 00:27:58

Paracetamol, Prostate and HIFU, Uncertainty - Oxygen and Heart Attacks

Evidence suggests Paracetamol is neither as effective or safe as previously thought for chronic pain; Prostate cancer and new targeted treatments with fewer side effects plus feedback following last week's special edition; And is giving oxygen in heart attacks a help or hindrance? Margaret McCartney and Carl Heneghan debate the first in a new mini-series investigating uncertainty in medicine.

Duration: 00:27:55

Prostate Cancer

One in 8 men in the UK will develop prostate cancer at some stage, but deciding who needs treatment - and when - is still far from clear. Mark Porter reports on two landmark trials that could provide some clarity, and hears from men and their doctors, faced with the dilemma of choosing the right course of action.

Duration: 00:27:55

Dying at Home, Familial Hypercholesterolaemia FH, Delirium

Most of us say we'd like to die at home but few of us actually achieve this wish - something the NHS is keen to change. An award-winning GP surgery in Lancaster, The King Street and University Medical Practice, has transformed the way they care for patients reaching the end of their life, twice winning the Gold Standards Framework Quality Hallmark Award. Dr Nour Ghazal tells Dr Mark Porter what they've done to ensure their patients have a say in how and where they would like to die and...

Duration: 00:27:52

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