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Medical Scribblings - 11 July 2007

A marvellous sight met me the other morning, there walking through Elsenham was a crocodile all dressed in yellow reflective jackets on its way to school. Why is it that, apart from Poland, we have the worse record for children being killed on the roads? Other countries, such as Holland, with the same density of population somehow manage a fraction of our losses. What’s the point of us trying to make sure that the kids are fit and healthy when they get mown down outside their home?

There are simple solutions to this such as footpaths well away from traffic and cycle tracks that are proper tracks and not some line painted on the side of the road. I went to northern France recently and they had lovely cycle tracks going through the coutryside which made a trip out a real pleasure. Have you tried cycling round the new airport? I have and you take your life in your hands. They have already spent Billions on it and are planning to spend more Billions. Please could we have safe cycle tracks so that people can get to work.

Having expressed myself on one of my pet hates – what’s the point of being a grumpy old man? -  it seems appropriate to move onto a very positive development in disease prevention. It may cause consternation in parts of the USA but they have developed a fantastic new vaccine to prevent 70% of cases of cervical cancer and 90% of genital warts. Once the NHS funding has been sorted out they should be vaccinating teenage girls to start with. I would highly recommend it to you as soon as it becomes freely available.

Talking of vaccination the boffins have been struggling for the last 25 years to develop a vaccine to prevent AIDS but without success so far. HIV is what they call a retrovirus and seems to be able to very cleverly incorporate itself into the very cells that are there to protect us. They may eventually do it but don’t hold your breath. What has been shown to work is a public education programme to persuade people to use a physical barrier and also, strangely enough, circumcision in men.

What else has been in the news in the medical world? Oh yes the ongoing saga of HRT. When it was thought up it seemed a marvellous idea relieving the suffering of many ladies who previously had suffered greatly at the menopause. It also seemed likely to reduce the risk of heart disease as we knew that this shot up after the menopause and quickly caught up with the rate for men. Then there was a study in the States that suggested that HRT increased the cardiovascular risk as well as upping the rate of breast cancer. There things seemed to rest for a time until someone re-analysed the figures and came to the conclusion that far from increasing the heart disease risk  HRT actually reduced it under the age of 60. This finding was confirmed by scans on the arteries of ladies of this age group. One is left a little perplexed that they don’t seem to be able to make up their minds and I am sure as a sufferer of menopausal symptoms you may well express yourself more forcibly. My advise to you is that if you are suffering from symptoms badly and don’t have a bad family history of breast cancer then they are probably a pretty safe drug.

What all this argument is about is the way that science works. You can admit that you got it wrong and think again. I find it so much more satisfactory than arternative therapies where it seems impossible to question their effectiveness.

John Schofield