Published on 24th July 2017 by lauram

Hello and welcome back to our news summary blog at The Medic Portal. This week we will be discussing health stories on the following themes: medical advances in transplant therapy, risk factors and prevention of dementia, and ethical issues in paediatrics and end of life.

Medical advances in transplant therapy

Zion Harvey is a 10-year old boy who made history as the world’s first child to have a double hand transplant. Two years on, he is able to feed and dress himself, as well as write and play baseball. These motor and coordination skills, along with the development of sensation in his hands, mean that his brain is being rewired to connect with the transplants. This has been described by the lead surgeon Dr Scott Levin as “remarkable”, as the brain normally forms these connections at a much younger age during normal development.

The hands should be functional for the rest of Harvey’s life, providing Harvey’s immune system does not begin to reject the transplanted tissue. It appears that this did begin to happen a number of times in the first year following the transplant, but was quickly halted with medication alterations. Harvey will require lifelong immunosuppressive therapy, which should prevent any future immune dysfunction.

The success of the transplant and further observations made about Harvey’s development may vastly influence the future of transplantation in children.

Risk factors and prevention of dementia

35% of the risk for developing dementia lies in modifiable lifestyle factors

A new study in the Lancet has shown that as much as 35% of the risk for developing dementia lies in modifiable lifestyle factors. This equates to a startling 1 in 3 cases that could be prevented if people act early in life to improve their lifestyle. The factors identified are as follows:

  • Mid-life hearing loss
  • Failure to complete secondary education
  • Smoking
  • Failure to seek early treatment for depression
  • Physical inactivity
  • Social isolation
  • High blood pressure
  • Obesity
  • Type 2 diabetes

The significance of this research lies in the potential for relieving the increasing burden on the healthcare and social care systems from a rapidly growing ageing population. Currently, dementia affects 1 in 14 of the over 65s, and costs the NHS roughly £26 billion a year. This is a tremendous increase from the £17 billion cost in 2007.

Implementation of targeted lifestyle advice, therefore, has the potential to go far in the battle against dementia, a condition which affects both physical and mental health, as well as having a huge impact on family members and carers.

Ethical issues in paediatrics and end of life

Charlie Gard is an 11-month year old baby with a rare genetic condition which has damaged his brain, heart, liver and kidneys. This has left him unable to breathe, open his eyes or move, and he is currently hospitalised at Great Ormond Street Hospital (GOSH). His story has been quite heavily covered in the media, and has sparked fierce ethical debates. This is due to his parents’ wishes that he be taken to America for experimental treatment, whilst his own doctors firmly believe that any further treatment is futile and should be withdrawn.

The ethical issues that arise here include the following: who should be making life-or-death decisions for children who do not have the capacity to do so? Some argue it should be the parents, as they have the ultimate responsibility for the child, whilst others believe it should be the doctor, due to their objective medical view of the patient. Furthermore, when is the right time for treatment to be withdrawn and a natural death allowed to occur? Some believe in the value of preserving life at all cost, whilst others argue that quality of life should be taken into consideration.

This week, the US doctor who offered to treat Gard has visited Great Ormond Street Hospital to discuss the case. Whether or not Gard will undergo the treatment remains to be seen.

Words: Mariam Al-Attar


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