What we know about ACE inhibitors, high blood pressure and COVID-19

 

 

by Dr Rupert Payne, Consultant Senior Lecturer in Primary Health Care, Centre for Academic Primary Care, University of Bristol

The COVID-19 pandemic has unsurprisingly been associated with a similar epidemic of social media misinformation. But there are also some genuine clinical issues of relevance to people with existing health conditions, who are known to be more vulnerable to the disease. One particular topic that has left patients and health professionals alike confused and alarmed is the suggestion that ACE inhibitor drugs may increase the dangers of COVID-19.

First introduced in the early 1980s, ACE (angiotensin-converting enzyme) inhibitors were initially used for the treatment of high blood pressure, but their role has grown over the years to include the management of heart failure, heart attacks, diabetes and kidney disease. Given that roughly one-fifth of the adult population in the UK has diagnosed hypertension, and other … Read more

Vaccinating children – why peace of mind should not be forgotten when it comes to funding

Gemma Lasseter

 

by Gemma Lasseter, Research Fellow, Centre for Academic Primary Care and NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol

In the UK, government policy on whether to fund new vaccines, or modify their availability, is based on advice from an independent scientific advisory group. This involves weighing up the benefits and costs, and then deciding whether a vaccine is value for money.

The idea is to find a balance between the cost of doing something (such as routinely vaccinating all children against a particular disease) and how much benefit you get from doing it (such as health gains by preventing disease and the associated economic savings).

Yet the current approach does not take into account many of the benefits that vaccinations offer and which set them apart from other health interventions. The fact that vaccinations are preventative rather than curative, for … Read more

What are the causes of unnecessary antibiotic prescribing?

 

 

By Christie Cabral, Research Fellow, Centre for Academic Primary Care, University of Bristol

Why do parents seeking evaluation, reassurance and information about their child’s cough end up with antibiotics from their GP? Research fellow Christie Cabral looks at the evidence.

GPs see a lot of children with respiratory tract infections (RTIs), usually presenting with a cough, high temperature or both. RTIs can be distressing and disruptive for children and parents but are mostly viral illnesses that will get better on their own: there is little that a GP can do to treat them.

However, many are prescribed unnecessary antibiotics that can lead to resistant bacteria. From our previous research, we know that parents often feel uncertain about the severity of an RTI and feel that it’s safer to consult a doctor.

They are usually seeking a medical evaluation, reassurance and information to help them understand and … Read more

SafeTea: An online intervention to prevent hot drink scalds in small children and improve burn first aid

Professor Alan Emond

 

 

Guest blog by Professor Alan Emond, Emeritus Professor of Child Health, Bristol Medical School, University of Bristol

SafeTea is a national campaign which aims to reduce hot drink scalds to young children and promote burns first aid. The launch of the intervention will be on 16 October 2019, National Burn Awareness Day. The target audience is parents, grandparents and carers of children under 5 across the UK.

Primary care centres can participate in the campaign by:

  • displaying posters, flyers or videos that are freely available on the SafeTea website. 
  • by following us on social media @SafeTeaCampaign on Twitter, Facebook, Instagram and YouTube
  • by taking the SafeTea pledge.

The key messages of the campaign are to:

  • Keep hot drinks away from young children
  • Never carry a hot drink whilst carrying a baby
  • Never pass a hot drink over the heads of young children
  • Make a
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Children with eczema: the link to food allergies is not clear cut

By Dr Matthew Ridd, GP and Senior Lecturer in Primary Healthcare, Centre for Academic Primary Care, University of Bristol
and Dr Robert Boyle, Consultant Paediatric Allergist, Imperial College London

Around one in five children have eczema – and even mild cases can have a big impact on both the child and their family. For many, symptoms will come and go before they start primary school, but for others it can indicate the beginning of a genetic tendency to develop allergic conditions such as hay fever or asthma (or both).

We also know that children with eczema are more likely to develop food allergies, especially if the condition starts in the first few months of life and is severe. Often parents will make the allergy diagnosis themselves – at the sudden onset of vomiting, diarrhoea or rash after eating scrambled egg, for example.

This can be frightening, but … Read more

Much we can do and even more to learn about COPD

 

Guest blog by Dr James Dodd
Consultant Senior Lecturer
Academic Respiratory Unit, University of Bristol
and Southmead Hospital, Bristol

What is COPD?

Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term which includes ‘chronic bronchitis’ and ‘emphysema’. It causes a progressive decline in lung function and health. It is common, affecting 2% of the adult population, and is projected to become the third leading cause of death in the UK. People with COPD experience breathlessness, cough and wheeze and often suffer with repeated chest infections. These ‘exacerbations’ are the second most common reason for emergency admissions to hospital.

Sadly, around two of the three million people with COPD in the UK remain undiagnosed, meaning that they live with debilitating symptoms for many years before receiving the support and advice they need. These ‘missing millions’ are the driving force behind COPD awareness month and World COPD Day.

It is … Read more

What’s normal in children’s respiratory infections? Bristol parents helped us find out

 

by Dr Emma Anderson
Senior Research Associate
Centre for Academic Primary Care

As any parent knows, children get coughs, colds and ear infections all the time. Symptoms of these respiratory infections – including runny nose, cough and sore throat – can seem never-ending.

In the EEPRIS Study, led by Professor Alastair Hay from the University of Bristol’s Centre for Academic Primary Care, we recruited parents across Bristol to tell us about their children’s respiratory symptoms as they became ill. Gathering information in the community means we are able to find out more about common respiratory illnesses than when we study those who have decided to consult their GP. It also gives us a more accurate picture of how likely parents are to consult for these common illnesses, something which has been surprisingly unclear.

Two of our main findings were that:

  • it takes up to three weeks for most
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Can a programme of supervised exercise improve the quality of life of men with advanced prostate cancer?

Dr Eileen Sutton

 

by By Dr Eileen Sutton
Senior Research Associate, Qualitative Lead on the STAMINA Study
Centre for Academic Primary Care

STAMINA is a five-year study funded by the NIHR’s Programme Grants for Applied Research scheme and is led by researchers from Sheffield Hallam University, with collaborators from Sheffield Teaching Hospitals, University of Leeds, University of Sheffield, Queen Mary University London, University of Bristol, University of York, Cardiff University, University of Edinburgh and Queen’s University, Belfast in partnership with Nuffield Health.

Why are we doing the research?

Prostate cancer is the most common cancer in men in the UK, with around 47,000 cases diagnosed each year. Androgen deprivation therapy (ADT) is a standard treatment for men with advanced prostate cancer but it is associated with significant side-effects which include fatigue, depression, sexual dysfunction, impairment of memory and concentration, increased fat mass and loss of muscle strength. ADT also increases the risk … Read more

Medicines have revolutionised treatment in the NHS – can this progress be sustained?

Dr Rupert Payne

 

by Dr Rupert Payne
Consultant Senior Lecturer in Primary Health Care
Centre for Academic Primary Care

The seventieth anniversary of the NHS has made me reflect on how proud I am to have contributed to its work for over the past twenty-odd years. Founded on 5 July 1948, the service continues to this day to operate to the same three core principles – meeting the needs of everyone, free at the point of delivery, and based on clinical need.

Aside from providing comprehensive, high-quality healthcare services to virtually the entire UK population, the other thing that the NHS is known for is the constant political bickering that carries on in the background, with criticisms about chronic under-funding and stealth privatisation. However, these are not new issues, with medicines an important reason for the challenges the NHS now faces.

In a response to concerns about rising costs, perhaps the first … Read more

Penicillin was discovered 90 years ago – and despite resistance, the future looks good for antibiotics

 

by Professor Alastair Hay
Professor of Primary Care
Centre for Academic Primary Care

When the NHS turned 70 this year, I was reminded of another anniversary which has had an enormous impact on healthcare over many years. Penicillin is 90 this year.

Discovered in September 1928 by Alexander Fleming, it was first used as a cure when George Paine treated eye infections with it in 1930. A method for mass production was devised by Howard Florey and Ernst Chain in 1940, and it was first mass produced in 1942, with half of that total supply used for one patient being treated for streptococcal septicaemia.

In 1944, 2.3m doses were produced in time for the Normandy landings of World War II. And it was then that the miracle of penicillin became clear. Soldiers who had previously died from septicaemia were surviving.

Expectations rose. If penicillin could cure septicaemia, what … Read more