Secondhand smoke linked to 30% increased stroke risk

Think just because you do not smoke that you are safe from the thousands of toxic chemicals contained in cigarettes?…Think again. Non-smokers who are regularly in the company of people lighting-up, may still be ingesting all those dangerous fumes and having their health put at jeopardy – through what is known as secondhand (passive) smoking.

It seems a new study emerges every single day that further demonstrates how bad smoking is for the body, and the latest research shows that non-smokers exposed to secondhand smoke can be at a significantly increased risk of suffering a stroke.

The study – published in the American Journal of Preventive Medicine - led by Angela M. Malek, PhD, from the Department of Public Health Sciences, Medical University of South Carolina, Charleston, found that secondhand smoke can raise the risk of developing a stroke by an estimated 30%.

Researchers analysed the national, population-based study ‘Reasons for Geographic and Racial Differences in Stroke’ (REGARDS), a study that assesses cardiovascular disease occurrences and death rates of people aged 45 or over.

Within the REGARDS database, 45% of the people were African-American and 55% were Caucasian. For the purpose of their study, the researchers focused on 22,000 individuals, of which 38% were African-American and 45% were males. Around 23% in total of these people were exposed to secondhand smoke.

Researchers delved into the information deeper to determine if certain types of stroke could be linked to smoking, applying adjustments as well as taking into account factors such as diabetes, hypertension and other cardiovascular diseases.

The findings demonstrate that from April 2003 to March 2012, study participants had reported 428 stroke. Of this total, 352 were ischemic, 50 were hemorrhagic and 26 were due to other subtypes of stroke. Even taking into account the variable factors, there was still a 30% risk of stroke for nonsmokers.

“Our findings suggest the possibility for adverse health outcomes such as stroke among nonsmokers exposed to SHS and add to the body of evidence supporting stricter smoking regulations,” commented Malek.

She added: “In the future, it is necessary for studies to analyse the role of heart diseases in the relationship established in this current research. Possible exposure to other environmental factors such as air pollutants in relation to stroke should also be explored.”

Erectile Dysfunction prescriptions soar 25% in a year

Just a week ago Medical Specialists® Pharmacy dramatically lowered the prices on ALL erectile dysfunction treatments, such as Viagra, generic sildenafil, Cialis, etc., and the response in the subsequent seven days has shocked even those at Medical Specialists®.

With this huge price crash, thousands of male patients from all over the UK suffering with impotence – and indeed other countries around the globe – have been using the online consultation service to submit orders for various erectile dysfunction treatments. To give an example of the price drop, 4 x Viagra 100mg tablets were previously priced at £55.95 (Inc. delivery to mainland UK), but are now priced at just £34.95.

Perhaps many have suffered in silence for too long and finally decided to seek help from Medical Specialists®, or were simply deterred by the cost of the medications, either way it seems our staggering cost reduction to patients has resulted in a soar in requests for erectile dysfunction treatments.

It is not just at Medical Specialists® though where requests for male impotence medications are coming in thick and fast, with new figures showing that prescriptions for erectile dysfunction drugs such as Viagra soaring by over 25% within a year in the UK, as costs reduced by 85.9% with the availability of generic versions from 2013.

According to statistics from the Health and Social Care Information Centre (HSCIC), last year there was found to be 1.7 million prescriptions dispensed for sildenafil (often sold as the branded Viagra), but is also obtainable under other trade names.  The HSCIC report analyses prescriptions dispensed by community pharmacists, dispensing doctors and in GP practices.

In comparison, there were 1.4 million prescriptions of sildenafil dispensed during 2013, and just one million back in 2004. For purely sildenafil alone, it was found that prescriptions increased by 21% during the previous year.

However, drugs for other conditions have seen a large increase in prescriptions too, with HSCIC figures showing that antidepressants, which includes medications for depressive illness, generalised anxiety disorder (GAD), obsessive-compulsive disorder, and panic attacks, increased by 7.2%, with 57.1 million dispensed last year, compared to 53.3 million in 2013. That means the number of dispensed prescriptions for antidepressants has almost doubled from the 29 million dispensed in 2004.

Other HSCIC stats show that in excess of 1.06 billion drugs were prescribed across England in 2014, a rise of 3.3% on the number prescribed during 2013 and an incredible rise of 55.2% on 2004.
Another finding was that the overall net ingredient cost of prescriptions in 2014 stood at £8.85 billion, representing a 2.6% rise of 2013 and 9.6% increase over the previous 10 years.

For the eighth successive year, the most amount of money went on diabetes drugs, with a 7% increase – rising by £55.3 million from 2013 to 2014, to reach £849.1 million.

Popular cholesterol drug Atorvastatin, a treatment that helps to cut the risk of heart attacks and strokes, was discovered to have the biggest rise in the number of items dispensed, with a four million rise since 2013.

Weight loss expert Steve Miller says fat doctors should be struck off

Overweight doctors should be forbidden from practising on the NHS as they are setting bad examples to the patients that go to see them, according to a leading weight loss expert.

Birmingham-born hypnotherapist Steve Miller runs his own clinic in his home town, and argues that fat doctors should be struck off and told to lose weight; one of many suggestions he has put forth as drastic measures to tackle Britain’s increasingly problematic obesity crisis.

In a written letter to NHS chief executive Simon Stevens, Mr Miller has argued for a much tougher approach with regards to those GPs found to be obese and setting a bad example to their patients, further suggesting that all NHS doctors should be subject to a yearly medical examination which will comprise of a weigh-in, to ensure they are maintaining a healthy weight.

Moreover, Mr Miller says that any doctor found to have a body mass index (BMI) in the overweight/obese categories should be forced to attend a privately funded boot camp in order to lose the excess weight.

If that wasn’t enough, the hypnotherapist has called for any overweight or obese GP who is not willing to attend the boot camp or agree to a personal training programme (at their own expense), should be held to disciplinary action and maybe even struck off if they don’t shed the weight.

Currently, NHS England already has an aim of decreasing sickness amongst staff, which includes obesity, by a third, which may save up to £550 million. This works out at roughly adding an extra 15,000 staff and 3.3 million extra working days.

One of the ways of achieving this will be through the introduction of voluntary weight management schemes for NHS employees, in addition to urging staff to actively travel to work (i.e. walking or cycling) and the ban of unhealthy, fatty food and drink items on the hospital premises.

As doctors are in a position of responsibility, Mr Miller says there should be tough ramifications for any overweight GP.

He said: “Doctors are role models for their patients and that means setting a good example in their actions as well as their words. But there are far too many overweight and obese doctors sitting behind desks in surgeries across the UK. For a doctor to let themselves turn into a lard bucket sends a terrible message. Fat doctors should be suspended from work until they get into shape and if they refuse to undertake a diet and exercise programme then they should be reported to the General Medical Council and struck off.That might sound harsh but obesity is the single biggest problem facing the NHS over the next 20 years and we have to get tough on it as a nation.

“That means a zero tolerance approach to fat doctors. It is laughable when a patient is told by a GP who looks like a Sumo wrestler that they need to lose a bit of weight. Patients take no notice and laugh away the advice. GP’s are paid out of the public purse and should remember that being in a position of power need to be seen as a role model for health. Fat GP’s are an advert for stuffing in yet more burgers and chips and swilling it down with a bottle of wine. It’s ridiculous that any doctor with a belly overhanging their trousers should think they are fit to dish out medical advice, frankly.”

Those with a good memory may recall 45-year-old Mr Miller presented the Sky1 television weight loss show ‘Fat Families’ back in 2011 and the controversial, and sometimes harshly blunt health guru is no stranger to weight struggles himself.

The outspoken Brummie – who specialises in anxiety, panic attacks, weight loss and confidence building – is now down to a trim 11 stone, but was four stone heavier in his mid-30s, managing to shed the pounds by simple lifestyle changes, such as walking more and eating less.

He added: “Simon Stevens needs to acknowledge the dangers of obesity and its acceptance in this country. We need to take action and I’m willing to step up if he will. The sooner we start speaking out, the sooner we start saving lives. Isn’t that the purpose of the NHS? It needs to start within the medical profession. Once they bring their own house in order then perhaps we have a chance of stemming the ever increasing tide of the obesity epidemic.

“GPs have a responsibility to manage their weight. No patient deserves to be advised by a fat GP who is lazier than they are. Overweight docs need to get their mind over the platter. They need to be hypnotised fast so they can lose weight and be an inspiration to obese patients. Fat GPs are a shockingly bad example to kids. Child obesity is out of control and a fat doctor does nothing to motivate overweight kids to slim down. Every GP needs to look in the mirror. If they see a fat bulge, they need to realise they will be perceived as a joke and their advice ignored.”

STIs increasing among gay men, according to PHE report

New statistics show that sexually transmitted infection rates amongst gay and bisexual men are spiralling across England.

A report published by Public Health England on 23 June gave a startling insight into the nation’s carefree/careless attitudes towards sex it seems, with to quote: “high levels of condomless sex” in general and “rapid” transmission of infections in HIV-positive men.

The report was compiled using the annual data for sexually transmitted infections (STIs) and national chlamydia screening programme (NCSP), which has been released for 2014.

Although across all groups in England, the number of sexually transmitted infections actually fell by 0.3% from the previous year, to 439,243 new cases, public health officials are becoming deeply concerned about the rise in STI cases among men who have sex with other men.

“We are particularly concerned about the large rise in diagnoses among gay men. Health promotion and education to increase risk awareness and encourage safer sexual behaviour remain the cornerstones of STI prevention,” commented Dr. Gwenda Hughes of the PHE, in a statement.

“Ensuring easy access to sexual health services and STI screening is a vital component in the control of STIs,” Hughes added, stating that STI control and the reduction in the STI infection should be made the first public health priority in the UK.

The problem of STIs is unsurprisingly rife across young people aged 25 or under and gay men (gay, bisexual and other men who have sex with men).

The Figures for last year depict a shocking 46% rise in syphilis infections, 32% increase for gonorrhoea and 26% in chlamydia.

Broken down into various STIs, the PHE report found:

• Syphilis infections increased from 2,375 to 3,477
• Gonorrhoea increased from 13,629 to 18,029
• Chlamydia diagnoses increased from 9,118 to 11,468
• Genital warts increased by 10% from 3,156 to 3,456

There remains a major worry regarding gonorrhoea due to the rise of antibiotic-resistant strains of the infection, making it tricky to treat.

Gay men are usually recommended to go for a HIV and STI test every year, or every three months if they are engaging in sex without a condom or with casual sexual partners.

Moreover, PHE advise that all sexually active under-25-year-olds should have a chlamydia test each year and also when they have a new sexual partner.

Dr Michael Brady, the medical director of the Terrence Higgins Trust, said: “The continued rise in both syphilis and gonorrhoea is a worry and evidence that we still have much to do to address the nation’s poor sexual health and rates of STIs in those most at risk.

“We should make better use of new technologies and approaches – local awareness raising through targeted social media based on the geographical breakdown of the data we are seeing today and an offer online testing – to reach those who are not accessing ‘traditional’ services.”

UK seizure of £15.8 million worth of counterfeit and unlicensed medicines and devices

Today (18 June) The Medicines and Healthcare products Regulatory Agency (MHRA) announced that a staggering haul of fake and unlicensed medicines and devices have been seized across Britain as part of an ongoing global operation.

The huge haul totals around £15.8 million and the seizures represent the biggest to be recorded in the UK. The types of drugs to be counterfeited include massive amounts of the usual suspects that are often imitated; erectile dysfunction and slimming pills, in addition to anaemia and narcolepsy tablets. Fake condoms and unlicensed foreign medicines were also seized.

The MHRA instigated the ‘Operation Pangea VIII’ initiative with INTERPOL, carrying out a series of worldwide drug raids during the week of 9 and 16 June, leading to 156 arrests in numerous different countries.

In news that comes as a delight to Medical Specialists®, after ourselves publishing several articles on how to spot an illegal website/fake ‘pharmacy’, Operation Pangea VIII also involved the shutting down of illicit websites that were duping customers with falsified, counterfeit and unlicensed medicines.  These websites were hit with a closure or suspension by removal of their domain name or payment facility.

Closer to home the MHRA enforcement officers joined forces with local police to conduct raids on known suspect addresses across Britain, addresses connected to the illegal online supply of potentially deadly medicines.

This led to a seizure of nearly 6.2 million doses of falsified, counterfeit and unlicensed medicines in the UK, 15,000 of which were found to be medical devices that had an estimated total value of £15.8 million. Thanks to UK operations, 1,380 websites were shut down, 339 being domestic sites.

MHRA Head of Enforcement, Alastair Jeffrey, said: “Operation Pangea is the global response to internet-facilitated medicines and devices crime. As a result of our intelligence-led enforcement operations we have seized £15.8 million worth of counterfeit and unlicensed medicines and 15,000 devices in the UK alone – which is almost twice as much as we recorded last year, and clear evidence that this is a growing concern that has to be taken seriously.

“Criminals involved in the illegal supply of medical products through the internet aren’t interested in your health – they are interested in your money and are able to get this by selling you a potentially dangerous product, or by stealing your bank details. To protect your health, visit your GP, get a correct diagnosis and buy medicines from a legitimate high street or registered pharmacy which can trade online.”

Most of the products seized in UK were imported from overseas, with India, China, Hong Kong and Singapore being the main countries in question.

With crooks always looking at new means to target potential customers, this has resulted in the MHRA investigating YouTube accounts and videos – leading to over 320 videos being taken off the site.

On a more global scale, regulators and custom officials analysed almost 150,000 packages and seized in excess of 20.7 million doses of unlicensed and counterfeit medicines, worth about £51.6 million.
Alex Lawther, from Border Force’s postal command, added: “Border Force regularly detects and seizes illegal and restricted products imported through the postal system including fake and unlicensed medicines. Our involvement in this operation with the MHRA demonstrates our commitment to combat this form of smuggling. Our message to the public is simple – don’t buy anything online unless you are certain it comes from a legitimate source.”

Quit smoking for 15 years…and it could be like you had never smoked!

All smokers take note: new research has shown that those successfully quit smoking for a sustained period of 15 years, can massively decrease the chance of suffering with heart failure or even dying.

U.S. Scientists made the remarkable discovery that people who stopped smoking almost two decades previously, had a comparable risk to those that had never smoked before.

Despite the findings clearly being a positive for all smokers across the globe, heavier smokers – i.e. those that had gone through at least a packet of cigarettes each day for 32 years or more – still had a slightly increased risk of health problems.

However, lead researcher Dr Ali Ahmed, from the Washington DC VA Medical Center, is pretty clear with the message…people either need to cut down on their smoking, stop smoking as early as they can, or simply never start smoking.

He commented: “While all individuals who quit smoking will benefit from a decreased chance of death, to achieve the full complement of health benefits of smoking cessation of one who has never smoked, smokers need to smoke less and quit early, and for those are not smokers – never start smoking.”

The findings were extracted via the most recent data from the Cardiovascular Health Study, which comprised of 2,556 people that had claimed to never smoked, 629 present smokers and 1,297 previous smokers. Every participant in the study was aged 65 or over, and 312 of the previous smokers admitted to heavy cigarette usage – smoking at least one pack daily for 32 years or more.

After a 13 year follow-up evaluation, the proportion of never smokers and previous smokers who had suffered heart failure, was found to be 21% in both groups. Within the group of former smokers that had consumed one pack per day for at least 32 years, nearly 30% suffered heart failure.

Comparison of mortality risks among present smokers and heavy smokers to never smokers was an interesting find. Researchers accounted for factors such as age, sex, race, education, other health conditions and medications, discovering that present smokers were around twice more likely to die from other diseases in comparison to those that had never smoked, and previous smokers were found to be 26% more likely to die compared to the never smokers.

Dr Ahmed told Reuters: “When one smokes, it induces atherosclerosis, or the buildup of plaque in the arteries. However, when one quits smoking, the buildup of plaque and risk of blood of clots decreases, allowing one’s cardiovascular risk to return to normal over time.”

Atherosclerosis is the medical term used when a person’s arteries have become narrower and harderned, usually caused by a high level of ‘bad’ low-density lipoprotein (LDL) cholesterol.
Statins like atorvastatin (Lipitor) and rosuvastatin (Crestor) are currently taken by around 7 million people in Britain, and work to decrease rates of LDL cholesterol by reducing the production of LDL cholesterol inside the liver. It is dangerous to have high rates of LDL cholesterol as this causes the atherosclerosis, resulting in a higher risk of heart attack, stroke and coronary heart disease.

Female Viagra drug Flibanserin on the cusp of FDA approval

Since Pfizer’s male impotence wonder drug Viagra first burst onto the scene an incredible 17 years ago, it was subsequently joined by Eli Lily’s Cialis and Bayer’s Levitra by 2003.

Over the next 12 years the industry has witnessed variations on these such as the lower-strength Cialis Daily tablets for the more ‘active’ male and Levitra orodispersible tablets – especially suitable for men who aren’t comfortable with swallowing pills, wanting to take it with some discretion and without the requirement of a glass of water.

Men also have the options of the newer erectile dysfunction treatment Spedra (Avanafil) or Vitaros cream – ideal for men that have not experienced success with the aforementioned PDE5 inhibitor tablets or cannot take PDE5s for medical reasons.

If all that wasn’t enough choice, men suffering with premature ejaculation have over-the-counter premature ejaculation treatments such as Stud 100 Spray, condoms containing benzocaine like Durex Performa (to prolong climax), whilst there is also prescription medication such as Priligy, which is taken orally and works to prolong a man’s sexual performance by an average of 200% to 300%.
Simply put, men are spoilt for choice when it comes to finding the right treatment option for sexual dysfunction, whether this be for persistent impotence or premature ejaculation problems.

So, what is there for women? If Medical Specialists® Pharmacy were to quiz our thousands of patients to come up with the name of an existing female sexual dysfunction treatment, we’d be surprised if anyone could muster a reply.

In early 2014 Medical Specialists® reported how British pharmaceutical company ORLIBID were developing a drug tentatively titled ‘ORL101’, aimed at boosting a woman’s sex drive, however no further information has been released about ORL101 since then.

However, Medical Specialists® are delighted to announce that a new pill to boost a woman’s libido could be one step closer after US experts gave its endorsement. This will be fantastic news for those that have fought for women’s sex drives to get a similar medical attention to deal put into it as the male treatments.

A panel of Food and Drug Administration (FDA) advisers decided to vote 18-6 in favour of recommending flibanserin, a daily pill nicknamed the ‘female Viagra’ and manufactured by Sprout Pharmaceuticals, who picked up the drug back in 2011 after its initial developer, Boehringer Ingelheim, decided to drop it.

The vote came following a testimony from various women who vigorously persuaded the agency to approve the drug and told of their fear of never being able to have sex again. The final judgement of course will have to come from the FDA themselves, with a verdict on suitability for public use due later this year.

Coincidentally, flibanserin, just like the discovery of Viagra, was an unintended find. The drug was firstly developed with the intention of treating depression, but wasn’t as effective for this purpose as expected.

Many of the 11,000 women involved in the trials did note that they were experiencing some rather unexpected side effects from the flibanserin. Increased sexual interest and overall, more satisfying sexual experiences than previous, were being commonly reported.

North Carolina drug maker Sprout Pharmaceuticals, have claimed that their clinical trials have demonstrated that women have experienced a 37% rise in sexual desire in comparison to a placebo. The women reported an average of between 0.5 and one more sexually satisfying events each month, compared to those women taking a placebo. In addition, they had higher scores on questionnaires on desire and scored lower on questions about stress.

The drug – which changes brain chemistry as opposed to Viagra increasing blood flow – isn’t without a chequered history though, with the FDA twice rejecting the drug since 2010, arguing flibanserin’s benefits did not outweigh the risks, which can include low blood pressure and fainting spells.

However, Susan Scanlan, chairwoman of Even The Score, hit back and noted that Viagra can have varying side effects, arguing that the FDA hasn’t approved flibanserin because of their discomfort with women taking control over their sexuality. “The implication is that men can be trusted to make a rational decision of risk versus reward and women can’t,” she said.

The FDA has highlighted female sexual dysfunction as one of 20 priority areas of unmet medical need, and is obviously a major and genuine health problem that needs to be addressed.

Keep checking the Medical Specialists® NHS Pharmacy website for further updates about flibanserin or other female sexual dysfunction products that may become available in the future, and we already have an extension range of male impotence and premature ejaculation treatments, some of which were mentioned earlier.