Manish Shah cited Angelina Jolie and Jade Goody to instil fear in his patients about their health.

Members of the Royal College of Nursing are refusing to do things like working unpaid hours.

Imagine a blood test that could spot whether you are ageing too quickly.

New research suggests it’s not the stuff of science fiction anymore.

The scientists analysed plasma – the cell-free, fluid part of blood – from more than 4 200 people between the ages of 18 and 95, and found a link between 373 proteins and ageing.

“We’ve known for a long time that measuring certain proteins in the blood can give you information about a person’s health status – lipoproteins for cardiovascular health, for example,” said study senior author Tony Wyss-Coray. He’s co-director of the Alzheimer’s Disease Research Center at Stanford University in California.

“But it hasn’t been appreciated that so many different proteins’ levels – roughly a third of all the ones we looked at – change markedly with advancing age,” he added in a university news release.

The study was published in the journal Nature Medicine.

“Proteins are the workhorses of the body’s constituent cells, and when their relative levels undergo substantial changes, it means you’ve changed, too,” Wyss-Coray explained. “Looking at thousands of them in plasma gives you a snapshot of what’s going on throughout the body.”

The findings suggest that physical ageing doesn’t occur at a steady pace, but is uneven and has three distinct surges – ages 34, 60 and 78.

A blood test in the pipeline

At those ages, there are spikes in levels of specific proteins in the blood with noticeable changes, according to the researchers.

Eventually, a blood test for these proteins might be able to identify people who are ageing more rapidly than normal and at increased risk for age-related conditions such as Alzheimer’s disease or heart disease.

Such a test might also help identify drugs or other factors that slow or speed ageing, the study authors said.

However, any clinical use of such a blood test is at least five to 10 years away, the researchers noted.

“Ideally, you’d want to know how virtually anything you took or did affects your physiological age,” Wyss-Coray said.

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A quarter of children’s hospital deaths are associated with severe malnutrition, a new report found.

South Africa’s healthcare system is not effectively dealing with stunting, the report states. According to the South African Child Gauge 2019, there has been no change in the prevalence of stunting in children in the past ten years. Stunting affects one in four children and is an indication of chronic malnutrition.

The report was compiled by the Children’s Institute at the University of Cape Town. The last time a report on children’s health was released was in 2009.

Preventable illnesses

The 286-page document focuses on how law reform and health systems impact children’s right to healthcare. The report delves into how South Africa’s proposed National Health Insurance bill could impact the country’s youngest population. It also highlights the causes of mortality in children and adolescents from 0 to 18.

The major causes of deaths for children under the age of five are preventable illnesses such as diarrhoea, malnutrition and pneumonia, the report found, with neonatal conditions in the lead. In 2002, most deaths were HIV-related – but the introduction of the prevention of mother-to-child transmission programme almost halved these deaths by 2012. Despite the availability of antiretroviral therapy, one in five children is still dying from HIV-related complications.

Additionally, in children between the ages of five and 19, the top cause of death was HIV, except in teenage boys, where interpersonal violence was responsible for one in three deaths, followed by road traffic injuries and then HIV.

First 1000 days matter 

The 2030 Sustainable Development Goals call for the end of preventable child deaths by reducing the under-five mortality rate to 25 deaths per 1 000 live births by 2030. South Africa has dropped from 56 deaths per 1 000 live births in 2009 to 32 deaths per 1 000 live births in 2019 — an almost 43% drop, according to the Minister of Health, Zweli Mkhize.

The country would need to reduce this number by about 22% to meet the target. To reach this goal, the report suggessts that intervention starts from day one until the child reaches the age of three. For this to happen, the Nurturing Care Framework approach needs to be adopted. This links the healthcare of a child to social welfare and education.

The health component includes “breastfeeding support, screening children for malnutrition, screening for perinatal depression, identifying early signs of pregnancy and encouraging early antenatal booking. ”It highlights the importance of good nutrition during these early years.

“Nutrition during the first 1 000 days affects not only a child’s growth, cognition and subsequent school attainment but also impacts on the lifelong risk of developing chronic disease,” the report states. These prevent conditions like stunting, which organisations such as the World Bank found can impact the future productivity and economy of a country. 

This is further compounded by an inadequate child support social grant, experts argue. According to the September 2019 Pietermaritzburg Economic Justice and Dignity Household Affordability Index, the child support grant is set 25% below the food poverty line and 26% below the cost to secure a basic nutritious diet for a small child aged between 10 and 13 years.

The grant is a fixed value and doesn’t increase as a child grows older. “It costs about R600 per month to buy a nutritionally balanced diet for a child, so the child support grant is only enough for two-thirds of a healthy diet for the child, if all the grant money is spent only on food for the child,” Dr Stephen Devereux, co-director of the Centre for Social Protection Institute of Development Studies, told Health-e in October. 

Creating a child-friendly healthcare workforce

As part of creating a healthcare system that works for children, it is important that issues of doctors and nurses’ shortages be addressed. The document states that there is a need to capacitate the system with health workers who will drive good services to the country’s youth. While younger children who are dependent on their parents or guardians are more likely to access healthcare services, it is more challenging to get adolescents to visit healthcare facilities, especially boys from the ages 15 to 19.

A recent study found that teenagers in this age group who are HIV positive are less likely to initiate HIV treatment once they discover their status. This is because the conventional way of accessing healthcare is not youth-friendly, the research found. It recommended that there should be the creation of more youth-friendly healthcare centres.

A sentiment that the report echoes is: “Health services require champions for children who are able to promote the needs of children and unite and lead the child health workforce.”

– Health-e News

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Nelisiwe Msomi

A UK coroner warns there could be more deaths unless regulation is tightened.

Income from fees jumps 10% in a year, with hourly charges of up to £4 levied.

An refugee doctor would love to work in the UK, and the NHS would love to have him – but there’s a hitch.

The patient said she was “traumatised” after feeling a cut in her belly button during surgery.

European guidelines on a form of heart disease are under review, following a Newsnight investigation.

A small, preliminary study suggests that a brain area called the hypothalamus appears to be about 6% smaller in women who use birth control pills.

But exactly what that means isn’t yet clear. In this study, women on the Pill had statistically significant increases in anger. Researchers also found a possible link with depression symptoms.

Not enough data to worry

The good news: They didn’t see any difference in women’s mental performance. And women who use the Pill shouldn’t search for other forms of birth control based on these findings, researchers said.

“There isn’t enough data here for anyone to worry,” said study author Dr Michael Lipton. “There’s more than a 50-year history of birth control pills. We’re not advising any changes (in your contraception) based on this preliminary finding.”

Still, he added, there may be clinical consequences that this study was too small to find.

Lipton is associate director of the Gruss Magnetic Resonance Research Center at Albert Einstein College of Medicine, in New York City.

Located at the base of the brain, the hypothalamus produces hormones. It also helps regulate essential body functions like temperature, sleep and heart rate, the researchers said.

Difference in hypothalamus volume

“There’s a lot of stuff packed in there,” Lipton said. “The hypothalamus covers a lot of basic body functions, like sleep regulation, reproductive regulation, ovulation, the menstrual cycle, sex drive, appetite, mood, reward-related behaviour and water [balance].”

Lipton and his team were initially studying differences in concussion recovery in female and male athletes. During that research, they realised there was a difference in hypothalamus volume in the women taking birth control pills.

Fifty women were part of the study. Twenty-one used birth control pills.

The US Centers for Disease Control and Prevention estimates that about 16% of women between 15 and 44 years of age take birth control pills. They are also used to treat other conditions, including irregular periods, cramps, acne, endometriosis and polycystic ovary syndrome.

The researchers only looked at birth control pills and not at other hormonal forms of birth control, such as under-the-skin implants or intrauterine devices. Because these forms of birth control release a steady, rather than a cyclical dose of hormones, their effects on the body or brain may be different, Lipton said.

Dr Minisha Sood, an endocrinologist at Lenox Hill Hospital in New York City, said it’s important to note the study’s small size, and that participants may have already had mood disorders.

No proven cause and effect

“This study is not likely to change my clinical practice in the immediate sense, though it may serve as a stepping stone to increase our understanding of the complex relationship between oral contraceptives and the brain,” Sood said.

Christine Metz, a professor at the Feinstein Institutes for Medical Research/Northwell Health in Manhasset, New York, also pointed out that the research does not prove cause and effect. “That means it’s too soon to know why these changes might have occurred,” she said.

Metz added that it’s also “important to note that changes in volume do not necessarily mean that there will be changes in brain function. With a smaller nose, do you smell less?”

She said she doesn’t think this is something women need to be worried about. The study was small, and it’s hard to distinguish the hypothalamus from surrounding brain tissue in imaging, Metz explained. Plus, the brain can change over time, so it’s possible changes in hypothalamus size might be reversed or improved over time.

The study was scheduled for presentation at a meeting of the Radiological Society of North America, in Chicago.

Findings presented at meetings are typically viewed as preliminary until they’ve been published in a peer-reviewed journal.

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