Tag: medicine

Regular paracetamol use ‘linked to raised blood pressure’

Long-term paracetamol use could increase the risk of heart disease and strokes in people with high blood pressure, a study suggests.

Patients who have a long-term prescription for the painkiller, usually used for the treatment of chronic pain, should opt for the lowest effective dose for the shortest possible time, researchers say.

The University of Edinburgh study, published in the scientific journal Circulation, is the first large randomised clinical trial to address this question and complements earlier work in observational studies.

Paracetamol was often suggested as a safer alternative to another class of painkillers called non-steroidal anti-inflammatory drugs (NSAIDs), which are known to increase blood pressure and risk of heart disease.

Professor David Webb, Principal Investigator and Chair of Therapeutics and Clinical Pharmacology at the University of Edinburgh, said: “We would recommend that clinicians start with a low dose of paracetamol, and increase the dose in stages, going no higher than needed to control pain.

“Given the substantial rises in blood pressure seen in some of our patients, there may be a benefit for clinicians to keep a closer eye on blood pressure in people with high blood pressure who newly start paracetamol for chronic pain.”

In the latest study, 110 patients with a history of high blood pressure were prescribed one gram of paracetamol four times a day – a routinely prescribed dose in patients with chronic pain – or a matched placebo for two weeks. All patients received both treatments, with the order randomised and blinded.

Those prescribed paracetamol saw a significant increase in their blood pressure, compared with those taking the placebo.

This rise was similar to that seen with non-steroidal anti-inflammatory drugs , and might be expected to increase the risk of heart disease or stroke by around 20 per cent, experts say.

The research team says the findings should lead to a review of long-term paracetamol prescriptions to patients – particularly those with high blood pressure, or those at particular risk of heart disease or stroke.

Professor James Dear, Chair of Clinical Pharmacology at the University of Edinburgh, said: “This study clearly shows that paracetamol – the world’s most used drug – increases blood pressure, one of the most important risk factors for heart attacks and strokes.

“Doctors and patients together should consider the risks versus the benefits of long-term paracetamol prescription, especially in patients at risk of cardiovascular disease.”

Dr Iain MacIntyre, Lead Investigator and Consultant in Clinical Pharmacology and Nephrology at NHS Lothian, added: “This is not about short-term use of paracetamol for headaches or fever, which is, of course, fine – but it does indicate a newly discovered risk for people who take it regularly over the longer term, usually for chronic pain.”

Green Shoots: Demand for CBD soars during lockdown

Association for the Cannabinoid Industry (ACI) and Centre for Medicinal Cannabis (CMC) have launched their report Green Shoots – Sowing The Seeds Of The New UK Cannabis Industry with a new assessment of the size of the UK consumer cannabidiol (CBD) market.

The sector is now estimated to generate £690 million in annual sales for 2021. This figure surpasses predictions made in the seminal market sizing study undertaken by the CMC in 2019 which estimated the market would be worth £526 million in 2021.

The report concludes that the UK now has the most evolved regulatory framework in the world for CBD, and other consumer cannabis extracts, citing recent interventions by the Foods Standards Agency – to regulate products as dietary supplements, and by the Home Office – to consider what are safe and tolerable levels of THC contained in products.

However, the report calls for more government intervention and investment to ensure that the UK optimises what it describes as ‘Britain’s quiet cannabis revolution’.

The report claims that, due to domestic restrictions on hemp cultivation and processing in the UK, the bulk of the profits for this industry are going overseas. This is because UK farmers must destroy the parts of the hemp crop which lucrative CBD is extracted from.

The report argues that the market represents a key growth sector for the UK and it is time for the government to adopt a proactive strategy to seize opportunities in the cannabinoids sector.

The report makes 20 recommendations drawing on a submission recently made to a new governmental Taskforce on Innovation, Growth and Regulatory Reform, established by British Prime Minister Boris Johnson in February, to stimulate post-COVID economic growth.

The report authors call for:

  • A dedicated agency to licence and oversee the industry
  • A new centre of excellence to fund, synthesise and promulgate the best new clinical evidence to boost the UK’s nascent medicinal cannabis market
  • Urgent reform of licensing policy to steer and harness the emerging scientific evidence across the whole spectrum: from agri-science and plant genetics, to novel synthetics, new therapies and clinical trials.

Steve Moore – Co-Founder and Strategic Counsel to the CMC and ACI, said: “With new government support the accidental consumer cannabis revolution that has allowed CBD to become available on every high street in the UK could become permanent, nurturing hundreds of new businesses, thousands of jobs and billions of pounds in exports.

“It’s hard to imagine there many more industries that could benefit almost immediately from the proposals set out in our report.”

Paul Birch, Co-Founder of the CMC and ACI, added: “The size of this cannabinoid sector is now impossible to ignore. Today’s report reveals that sales of CBD products up to the year end of April 2021 are valued at £690m, almost a third higher than our last projection in 2019.

“Almost without notice and certainly by accident rather than design, the UK has improbably become the world’s second largest consumer cannabinoids market.”

Week of events planned to celebrate pioneer of medicine

On 12 August, 1865, an 11-year-old boy named James Greenlees was rushed to Glasgow Royal Infirmary (GRI) after being run over by a metal-wheeled cart, which crushed his left leg.

Undergoing surgery then meant a 50/50 chance of survival. However, that day, he was operated on by the house surgeon, a 38-year-old Englishman named Joseph Lister, who was developing a new antiseptic technique to reduce the appalling mortality rate.

Lister cleaned the dirt from the wound, operated on the fracture and applied a dressing of carbolic acid. There was no infection, no sepsis or gangrene and the wound began to heal. After six weeks, the boy was discharged, leg intact and fully recovered to return to his grateful family.

Now more than 150 years on from pioneering work that led to the discovery of antiseptic surgery, the life and legacy of Joseph Lister is being celebrated by The Friends of Glasgow Royal Infirmary (FOGRI) a new charity, set up in May 2020 to celebrate the history of the place where Lister’s work took place, Glasgow Royal Infirmary.

The charity’s Chairperson is Prof Ross Lorimer, a retired Professor of Cardiology at GRI and former President of The Royal College of Physicians and Surgeons of Glasgow (RCPSG).

#Listerweek, in association with the RCPSG, will be the charity’s very first event and it will be held virtually and be freely available to anyone who is interested. #Listerweek runs from 22nd to 26th February with daily presentations, a virtual exhibition and a Twitter takeover from the acclaimed author and medical historian, Lindsey Fitzharris.

FOGRI plan to organise several more events to highlight the incredible history and accomplishments associated with GRI. #GRIwomensweek, expected to be held in the spring and in association with The Friends of the Necropolis, will commemorate key female figures in the hospital’s history including Rebecca Strong, Ellen Brown Orr and Bella McDiarmid.

John Stuart, who started his nurse training in the GRI and who recently retired as Chief Nurse after a career of almost 40 years, is one of the founding members of the charity.

He said: “The hospital is the oldest in Glasgow and many Glaswegians have a connection to GRI. Celebrating Lister seemed an obvious choice for our first event because his discoveries have had such an impact on healthcare and he made them whilst working at GRI.

“Lots of people use Listerine mouthwash but most will not make the connection – it is named after Lister, the father of antisepsis. Lister revolutionised surgery throughout the world. There are many notable figures who have worked within these walls and we wanted to bring people together by sharing the accomplishments associated with GRI over the 226 years since it opened – and who better to start with than one of our most famous sons?”

John, together with three of his colleagues, Dr Morven McElroy, Dr Hilary Wilson and Dr Kate Stevens came up with the idea for #Listerweek. 

In this current climate where life is drastically different, a shared love of the GRI campus and history has created a strong sense of camaraderie within the hospital and beyond. They hope that the feeling of friendship and teamwork will endure for many years to come and that a common love of the GRI buildings and history can continue to bring everyone together. All four relish the opportunity to share the fascinating tales of GRI in days gone by with the wider community.

Dr Morven added: “We are lucky in many ways because we can still come to our work. Our work is a privilege – we get to spend time talking to people, learning about their lives and helping them. Every year, when new members of staff begin their careers, they enjoy hearing about and seeing the history within GRI.”

You can register for the #Listerweek presentations on The Friends of GRI website: http://friendsofgri.org/  

They will also be available on YouTube and Twitter. You can follow the charity on Twitter @friendsofgri

Pictured (left to right): Dr Kate Stevens, Dr Hilary Wilson and Dr Morven McElroy at Glasgow Royal Infirmary.

New road named after ‘brilliant’ emergency doctor

Staff at the Royal Infirmary of Edinburgh have paid tribute to a “brilliant” former colleague by naming a road on the hospital campus after him.

Colleagues have honoured the late Dr Robin Gordon Mitchell by naming the new road “Robin Mitchell Way”. Continue reading New road named after ‘brilliant’ emergency doctor

Homeothapy no more for NHS Lothian

homeopathyNHS Lothian will cease to provide homeopathic services following a meeting of NHS Lothian’s board on 26 June. The decision followed recommendations made by the Healthcare Governance Committee and is in line with the recent survey results of the homeopathy public consultation.

The consultation and survey, led by the Midlothian Community Health Partnership, asked whether NHS Lothian should pay for homeopathic services in Lothian. The survey results showed that 72 per cent of all those who responded were against the service continuing to be funded by NHS Lothian with 27 per cent in favour of the status quo and 1 per cent undecided. The results also showed that people who lived in the NHS Lothian health board area responded similarly, with more than 74 per cent against the health board continuing to pay for homeopathy and approximately 25 per cent in favour.

Professor Alex McMahon, Director of Strategic Planning, Performance Reporting and Information, NHS Lothian said:  “We have consulted the public and listened to their views and the survey results are clear in showing that the majority of people who took part are against us continuing to provide homeopathic services. The majority of respondents cited lack of evidence for homeopathy and supported investing the funds currently spent on this service into other proven healthcare services.”

In total there were 3,720 responses to the questionnaire, which include 3,350 electronic and 367 paper responses.

There are approximately 200 new referrals each year to the homeopathy service with 1300-1500 return appointments. Approximately 20 new referrals are received per annum from other health boards.

The initial report detailing the consultation process and survey results is available at:

http://www.nhslothian.scot.nhs.uk/OurOrganisation/Consultations/Past/Homeopathy/Documents/NHSLothianHomeopathyConsultationReport.pdf

It provides a breakdown of returns both online and paper copies as well as by Lothian residents, non Lothian residents and those who chose not to indicate where they lived.

NHS Lothian