The media does publish “good news” – but far too early, raising expectations unreasonably…. Do you know what is not covered in your Regional Health service?

The media does publish “good news” – but far too early, raising expectations unreasonably. Eastern researchers are not held in great esteem and this work on prevention of cataracts needs to be validated and confirmed in the West. Meanwhile, for many years to come, second cataracts will be rationed out by some post-code administrations, and prevention of the speed of dementia onset will suffer the same covert rationing… Do you know what is not covered in your Regional Health service?Oliver Moody in The Times 22nd July 2015 reports: Cataract eyedrop treatment offers thousands hope

Eyedrops that may cure cataracts have been developed by scientists in a breakthrough that could eliminate the need for surgery. British doctors carry out an estimated 300,000 operations to remove clouded lenses each year, making it the most common surgical procedure in the country.

Although the operations are cheap and take as little as half an hour under local anaesthetic, a drug that can sort out the condition without the need for patients to go under the knife would be a significant advance.

A team of Chinese scientists studied the DNA of two families with a genetic predisposition to cataracts and found that they shared mutations of a gene called LSS, linked to the production of an important structural molecule.

The lens, which refracts light on to the retina at the back of the eye, is made up of millions of slender, fibrous cells containing proteins called crystallins, whose density plays a role in determining the clarity of a person’s vision.

Cataracts form when these proteins become damaged and the cells make opaque clumps that scatter light. Lanosterol, an enzyme produced by the LSS gene, appears to break these structures down in the healthy eye and keep cataracts at bay.

Tested on cloudy lenses taken from rabbits and on live dogs with cataracts, the compound was found to make their eyes significantly clearer and to break up the clusters of proteins on a molecular level. Scientists hope that it will have the same effect on people.

“Cataracts are the leading cause of blindness and millions of patients every year undergo cataract surgery to remove the opacified lenses,” they wrote in Nature. “The surgery, although very successful, is nonetheless associated with complications and morbidities. Therefore, pharmacological treatment to reverse cataracts could have large health and economic impacts.”

In an accompanying editorial J Fielding Hejtmancik of the US National Eye Institute said that the drug showed great promise. “The potential for this finding to be translated into the first practical pharmacological prevention, or even treatment, of human cataracts could not come at a more opportune time,” he wrote.

Because it has to bend light with such precision, the lens is one of the most delicately structured parts of the body, and the crystallin proteins that govern its shape are some of the densest human tissues.

As people age these proteins are not replaced and the fibre cells in the lens lose their alignment, often leading to a natural clouding effect in the eyes of old people. The cells can also be damaged by ultraviolet light from the sun.

Dr Hejtmancik said that a drug for treating or preventing cataracts would be of particular use in places where surgery was not cheaply available.

“Although surgery to remove cataracts is efficacious and safe, ageing populations around the world are predicted to require a doubling of cataract surgery in the next 20 years,” he wrote.

“The same population demographics suggest that the need for surgery could be reduced by almost half.”

Tom Whipple in the same paper reports: New drug could slow progress of Alzheimer’s

….After decades of failed attempts costing pharmaceutical companies billions of pounds, a manufacturer has released the results of a human trial that it says shows that it is possible to slow the rate of decline in patients with the disease.

…Although the effect of the new drug, solanezumab, was small, researchers said that it could have exploited a crucial chink in the disease’s armour, pointing the way to better treatments. However, others cautioned that the trial was too small to consider the results a breakthrough in what remains a poorly understood neurological illness….

Gone, but not forgotten | The Economist




This entry was posted in A Personal View, Good News, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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