NHS analyses the news - behind the news

Quando as notícias precisam de ser aprofundadas esta é sempre uma excelente fonte de análise dos estudos que vão saindo (em Inglês):

https://www.nhs.uk/news/

Citando:
"Behind the Headlines

Your guide to the science that makes the news

Categories

Cancer

Genetics and stem cells

Food and diet

Obesity

Neurology

Lifestyle and exercise

Older people

Heart and lungs

Medication

Pregnancy and child

Mental health

Medical practice

Diabetes

"

Serviço Nacional de Saúde do RU e medicina de precisão

https://www.theguardian.com/science/2018/jul/03/nhs-routine-dna-tests-precision-cancer-tumour-screening

Citando:
"People in England will have access to DNA tests on an unprecedented scale from the autumn when the NHS becomes the first health service in the world to routinely offer genomic medicine.

From 1 October, hospitals across England will be connected to specialist centres that read, analyse and interpret patient DNA to help diagnose rare diseases, match patients to the most effective treatments, and reduce adverse drug reactions.

The move marks a big step towards “precision medicine”, which offers more efficient therapies that are tailored to individual patients.

Under the service, new cancer patients will routinely have their tumour DNA screened for key mutations that can point doctors towards the best drug to use in treatment, or to clinical trials of experimental therapies that patients are likely to benefit from."

Behind the Headlines - Your guide to the science that makes the news

Do SNS do Reino Unido, esta é a melhor forma de descodificar as notícias sobre saúde na comunicação social (reviews dos estudos e das fontes e das fontes de financiamento - ou falta delas - por quem percebe do assunto - estudos e medicina):

https://www.nhs.uk/news/

Anti-ácidos associados a morte prematura

http://www.nhs.uk/news/2017/07July/Pages/Heartburn-drugs-linked-to-premature-death.aspx
Citando:
"Millions of people taking common heartburn and indigestion medications could be at an increased risk of death," The Guardian reports after a US study found people taking proton pump inhibitors (PPIs) had a slightly higher risk of death than the control group."

Álcool e cancro da mama?

http://www.dailymail.co.uk/health/article-4532240/One-small-glass-wine-day-raises-breast-cancer-risk.html

Citação:
"Even following safe drinking guidelines of 14 units a week could endanger health
Daily glass of wine raises risk of pre-menopausal breast cancer by 5 per cent 
Also raises risk of post-menopausal breast cancer by 9 per centc.12,000 breast cancer cases could be prevented per year if noone drank alcohol"

Teste reduz em um terço probabilidade de ter cancro do intestino (NHS)

https://www.theguardian.com/society/2017/feb/22/new-screening-test-cuts-bowel-cancer-risk-study

Citando:
"A one-off screening test being introduced across the NHS cuts the risk of developing bowel cancer by a third, a long-term study has found.

The test, which is being rolled out across England, will invite men and women to have bowel scope screening around the time of their 55th birthday.

This is in addition to the current test from the age of 60, the faecal occult blood test (FOB), which is posted to people’s homes.

FOB detects blood hidden in small samples of faeces, with further tests recommended if blood is detected."

Arroz e intoxicações alimentares?

O arroz (segundo o NHS) deve ser devidamente guardado e reaquecido apenas uma vez:
http://www.independent.co.uk/life-style/reheat-leftover-rice-food-poisoning-a7655816.html

Citando:
"So uncooked rice often contains spores (cells capable of reproducing quickly) of Bacillus cereus — a bacteria strand that can cause food poisoning — that can survive when rice is cooked.

And if the rice is left standing at room temperature after it's been boiled, the spores can grow into bacteria, which will ultimately multiply and may produce toxins that cause vomiting or diarrhea.

The longer cooked rice is left at room temperature, the more likely it is that the bacteria will make the rice unsafe to eat — meaning it's vital that you store your rice at the right way quickly if you're hoping to reheat it later.

So, how do you increase the chances of avoiding food poisoning all together? First off, serve rice as soon as it's been cooked, and cool any leftovers as quickly as possible. The NHS recommends within an hour, ideally. You can then keep the rice in the fridge (but for no more than one day) before reheating."

Ai os viçosos cabelos da juventude e a juventude...

... À distância de uma proteína estudada em ratos (outro estudo publicado esta semana):
http://www.nhs.uk/news/2017/03March/Pages/Modified-protein-promotes-hair-growth-and-reverses-ageing-in-mice.aspx
Citando:
"Researchers investigated whether a modified version of a protein called FOXO4-DRI was able to "seek and destroy" senescent cells from mice, in the hope this may counteract signs of ageing.
Researchers used naturally ageing mice as well as mice genetically modified to age more rapidly. They exposed both sets of mice to toxic chemotherapy drugs to place additional stress on their cellular functions.
They found FOXO4-DRI was able to neutralise toxicity caused by chemotherapy in the rapidly ageing and naturally ageing mice. It was also able to counteract loss of liver and kidney function, frailty and loss of fur density in the mice.
This is very early stage animal research and further studies are needed before FOXO4-DRI can be tested in humans.
It is likely that further research on FOXO4-DRI will be carried out, as a drug that could treat both hair loss and reverse some of the effects of ageing would have considerable commercial potential."

Linhas orientadoras para o exercício fisico (adultos)

O sítio do NHS tem as linhas orientadoras para o RU:

http://www.nhs.uk/Livewell/fitness/pages/physical-activity-guidelines-for-adults.aspx

Resumo (PDF) aqui.

Citando:
"Guidelines for adults aged 19-64

To stay healthy, adults aged 19-64 should try to be active daily and should do:

at least 150 minutes of moderate aerobic activity such as cycling or fast walking every week, and  strength exercises on two or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms).  

OR

75 minutes of vigorous aerobic activity, such as running or a game of singles tennis every week, andstrength exercises on two or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms). 

OR

A mix of moderate and vigorous aerobic activity every week. For example, two 30-minute runs plus 30 minutes of fast walking equates to 150 minutes of moderate aerobic activity, andstrength exercises on two or more days a week that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms).  

A good rule is that one minute of vigorous activity provides the same health benefits as two minutes of moderate activity.

One way to do your recommended 150 minutes of weekly physical activity is to do 30 minutes on 5 days a week."

Muito mais detalhes na ligação de cima (assim como linhas orientadoras para as outras faixas etárias).

Exercício físico como a melhor maneira de evitar a reincidência de cancro da mama

Mais uma excelente revisão das notícias (e estudo) que referem que o exercício físico é a melhor maneira de prevenir a reincidência do cancro da mama. As conclusões do perito do NHS são que o estudo é interessante do ponto de vista de analisar o impacto do estilo de vida sobre o cancro da mama apesar de ter algumas limitações (bias effect, etc.):
http://www.nhs.uk/news/2017/02February/Pages/Exercise-most-proven-method-to-prevent-return-of-breast-cancer.aspx

Citando:
"The researchers' review of evidence found that physical activity had the strongest reported effect on reducing the risk of breast cancer recurring and dying from breast cancer.

Following the recommended 150 minutes of moderate to vigorous exercise or 75 minutes of vigorous exercise per week guidance, as well as two to three weekly sessions of strength training, can help reduce the risk of breast cancer returning and death from the disease.

The effects of treatments such as surgery and chemotherapy can take a toll on motivation to exercise. But clinical guidelines recommend a gradual return to regular exercise."

O teste ao cancro por análise ao hálito (revisitado pelo NHS)

A análise do NHS (que é o SNS do Reino Unido) às notícias que circularam recentemente (o estudo é muito preliminar, não estava disponível para análise e ainda é muito cedo para se saber se poderá ser utilizado para construir o tal "breathaliser"):
http://www.nhs.uk/news/2017/01January/Pages/breath-test-shows-potential-for-detecting-cancer.aspx




Citando:
"The study is currently only available as a published protocol and poster presentation with accompanying press release. A full study publication is not available so we can't fully critique the methods and analysis.
Worldwide, OGC cancers account for around 1.4 million diagnoses a year but diagnosis tends to be late and therefore survival rates are low.
At the moment these cancers can only be diagnosed using endoscopy, which involves a camera attached to a flexible tube being passed down the throat. The procedure can be uncomfortable and is costly to the NHS.
A breath test that is able to identify the "chemical signature" of a cancer could be an ideal way to indicate a cancer diagnosis and help decide whether further invasive investigations are needed. It would hopefully enable more patients to be diagnosed at an earlier stage of the disease."

Nova combinação de drogas prolonga um pouco a esperança de vida (Cancro Pâncreas)

http://www.nhs.uk/news/2017/01January/Pages/New-drug-treatment-for-pancreatic-cancer-extends-survival.aspx
Citando:
"The trial showed people lived an average of 2.5 months longer if they took two drugs than if they took just one. Pancreatic cancer has a poor outlook compared with many other cancers.
Using information from the study, researchers estimated that the chances of people living for five years were 28.8% for those who took both drugs, compared with 16.3% for those treated with one drug.
However, not everyone involved in the trial was followed up for five years, so we don't know how reliable these longer-term estimates are. 
The researchers say the two-drug combination should be "the new standard of care" for people who've had surgery for pancreatic cancer.
But people who took both drugs were more likely to stop treatment early because of the toxic side effects of chemotherapy.
This is an important consideration for people whose treatment can only prolong life and not achieve a cure, as there is always going to be a trade-off between survival time and quality of life."

Estar o dia todo sentado acelera o envelhecimento (afecta ADN)

Artigo com métricas quantitativas interessantes relativas aos telómeros (e crítico negativamente acerca da utilidade do estudo sobre estar sentado acelerar o envelhecimento do ADN):
http://www.nhs.uk/news/2017/01January/Pages/Sitting-down-all-day-may-accelerate-DNA-ageing.aspx


Citando:
"Telomeres are measured in the small sections of nucleic acids that make up DNA, known as base pairs. 
Among women in the study who did less than about 40 minutes of physical activity a day, those who sat longest had shorter telomeres by an average 170 base pairs.
The researchers say telomeres shorten at a rate of 21 base pairs a year – using a rough "back of a fag packet" calculation, 170 equals about eight years.
Sitting time did not seem linked to telomere length for women who did at least 30 minutes of physical activity a day."

Alternativa de biópsia à próstata com maior taxa de detecção

Evolução interessante uma vez que a biópsia tinha efeitos secundarios possíveis como disfunção eréctil e uma taxa de detecção correcta (de tumores agressivos que requerem atenção imediata) muito baixa:
http://www.bbc.com/news/health-38665618
Citando:
"The biggest leap in diagnosing prostate cancer "in decades" has been made using new scanning equipment, say doctors and campaigners.
Using advanced MRI nearly doubles the number of aggressive tumours that are caught.
And the trial on 576 men, published in the Lancet, showed more than a quarter could be spared invasive biopsies, which can lead to severe side-effects.
The NHS is already reviewing whether the scans can be introduced widely.
Prostate cancer is the most common cancer in British men (...)"
"If men have high prostate specific antigen (PSA) levels in the blood, they go for a biopsy.
Twelve needles then take random samples from the whole of the prostate.
It can miss a cancer that is there, fail to spot whether it is aggressive, and cause side-effects including bleeding, serious infections and erectile dysfunction.
"Taking a random biopsy from the breast would not be accepted, but we accept that in prostate," said Dr Hashim Ahmed, a consultant and one of the researchers.
Around 100,000 to 120,000 men go through this every year in the UK."
(...)
"93% of aggressive cancers were detected by using the MRI scan to guide the biopsy compared with just 48% when the biopsy was done at random."

O álcool e as calorias

Artigo interessante com alguma informação das calorias médias de bebidas comuns e a necessidade de inclusão dessa informação nos rótulos para maior consciencialização de quem bebe:

http://www.bbc.com/news/uk-35211341


Citando:
"The LGA says calories from alcohol are classed as "empty calories", with no nutritional value, and by drinking alcohol, the amount of fat the body burns for energy is reduced. "
(...)
"It also says a pint of cider at 4.5% has 216 calories and is the equivalent to three-quarters of a burger, while a single spirit at 40% is 61 calories or an eighth of a burger.
Over 24 hours, drinking five pints of beer at 4% strength is the equivalent to eating more than three burgers. A bottle of wine - about four small 175 ml glasses - has the same calorie count as more than two burgers, the association says."


@2012-12-20: Remoção dos 50 vol. e quotes

NHS está a pensar recomendar exame ao fígado para prevenir cirrose

A cirrose quando apresenta sintomas já está em estado adiantado. O SNS do RU está em vias de recomendar um exame médico que detecte alterações precocemente (não invasivo, alternativa a biópsia):
http://www.bbc.com/news/health-38364331
Citando:
"Dr Andrew Fowell, liver expert at the Portsmouth Hospitals NHS Trust, said: "Identifying people who are at risk of liver disease and offering them non-invasive testing to diagnose cirrhosis is key to ensuring they are given the treatment and support they need early enough to prevent serious complications.
"Ten years ago diagnosis of cirrhosis would often require a liver biopsy, but now with advances in non-invasive testing it is much easier for patients and health professionals to make a diagnosis."
The draft quality standard from NICE recommends a non-invasive scan called transient elastography which uses ultrasound and low-frequency elastic waves to check the liver. A consultation on the draft document is open until February 2017."


Sobre os limites: 5 garrafas de vinho/semana (50 volumes) ou 3,5 para as senhoras.
Citando:
"Women who regularly drink more than three-and-a-half bottles of wine a week should get their livers checked, says new draft advice for England.
For men, the threshold is five bottles of wine a week or 50 units of alcohol, says the National Institute for Health and Care Excellence.
The organisation says GPs should refer "harmful" drinkers for liver scans.
Cirrhosis can be silent until the damage becomes so extensive it stops the liver working."
@2016-12-21: info sobre limites semanais.

Toma prolongada de analgésicos em mulheres associada a perda de audiçao? (6 anos - NHS)

Citando:
"Women who take paracetamol or ibuprofen just twice a week could be damaging their hearing permanently," the Daily Mail reports.
A US study found an association between the long-term use of these widely used painkillers and reported hearing loss.
Researchers calculated just over 1 in 20 (5.5%) hearing loss cases in their study could have been the result of painkiller use.
But they say it's not possible for this study to prove the drugs caused the hearing problems.
Previous studies have linked aspirin, paracetamol, and non-steroidal anti-inflammatory drug (NSAID) types of painkiller, such as ibuprofen, with hearing loss."

Efeitos secundários de Ibuprofen (Brufen)? (analgésico)

Efeitos secundários de Ibuprofen (Brufen)? A lista de efeitos secundários é sempre assustadora nestes medicamentos ditos comuns (já leram a bula?). Eis alguém a quem um ipobrufen fez mal:


http://www.dailymail.co.uk/femail/article-4022112/It-truly-horrendous-mother-took-ibuprofen-common-cold-ended-hospital-INTERNAL-BLEEDING-despite-sticking-recommended-dose.html


Sobre o medicamento (NHS):
http://www.nhs.uk/Conditions/Painkillers-ibuprofen/Pages/Introduction.aspx

Impacto do desporto na redução da mortalidade: O ténis é desporto rei?

Um estudo (algo limitado) sobre o impacto do desporto na redução da mortalidade foi publicado. Análise do SNS do RU:
http://www.nhs.uk/news/2016/11November/Pages/Want-to-live-longer-Try-racquet-sports-recommends-study.aspx


Citando:
"A study looking at the impact of individual sports on mortality found racquet sports reduced the risk of death by around 47%.
Researchers also found reduced risks of death for people who took part in cycling, swimming and aerobics.
They didn't find such effects for people who took part in rugby, football or running – although this unexpected finding may be explained by the low number of deaths, which may have skewed the statistics. The smaller the data set, the bigger the chance of the data being influenced by chance.
While the researchers found taking part in some sports reduced the risk of death compared to not taking part, they did not directly compare the benefits of different sports. That means we can't say which sport is "best" for health.
What is clear from the study is that any sort of regular physical activity is likely to help us stay healthier and live longer."
(...)
The study was carried out by researchers from the UKK Institute in Finland, University of Edinburgh, University of Oxford, Loughborough University and University of Exeter in the UK, Victoria University and University of Sydney in Australia, and University of Graz in Austria. No information about funding was provided."

Superbugs e ingrediente desinfectante

Quando uma coisa que se destina a resolver um problema, cria outro:


Citando:
"A laboratory study found the ingredient chlorhexidine, used in a wide range of antiseptic products, increased bacterial resistance to the antibiotic colistin.
Despite the headline to the contrary, researchers did not specifically test mouthwash or any other household products.
Colistin is what is known as an "antibiotic of last resort" and is used to treat Klebsiella pneumoniae bacterium that has evolved resistance to other more widely used antibiotics."