Belfast scientists say aspirin could reverse tooth decay

Tooth cavityImage copyright Getty Images Image caption Tooth decay can lead to cavities forming

Aspirin could reverse the effects of tooth decay and could lead to fewer fillings being needed in the future, researchers in Belfast have said.

Initial research at Queen's University has found aspirin stimulates stem cells in teeth, enhancing tooth regeneration.

Tooth decay, the most common dental disease, leads to the inflammation of the tooth nerve, causing toothache.

The British Dental Association reported in 2016 that 72% of 15-year-olds in Northern Ireland have dental decay.

That figure compared to 44% in England and 63% in Wales.

Aspirin (acetylsalicylic acid) is a drug that has been used for many years as a painkiller.It has an anti-inflammatory action, and is used to relieve headache, menstrual pain and muscle aches.It costs one penny a tablet.

Image caption Tooth decay is usually caused by a build-up of plaque, bacteria in plaque produce acids which weakens the enamel of the teeth

Teeth naturally have limited regenerative abilities.They can produce a thin band of dentine - the layer just below the enamel - if the inner dental pulp becomes exposed, but this cannot repair a large cavity.

Current treatment for tooth decay involves fillings, which may need to be replaced many times during the lifetime of the tooth.

Prof Ikhlas El Karim is a senior lecturer in the School of Medicine, Dentistry and Biomedical Sciences at Queen's University Belfast.

Her research focuses on dental stem cells found in teeth and how dentists can enhance their ability to regenerate and repair damaged teeth, removing the need for fillings.

The research findings, to be presented on Thursday at the British Society for Oral and Dental Research annual conference, show that aspirin can enhance the function of those stem cells, thus helping self-repair by regenerating lost tooth structure.

Image copyright Getty Images Image caption The fact that aspirin is already a licensed drug should help the development of the treatment, the researchers say

"Ideally, what we're really reporting here is that we're hoping to be able to develop a therapy [so] that the teeth could repair themselves," she said.

"This is going to be gradual, it's not going to be the end of the filling straight away."

The researchers collated large amounts of previous research data to indentify aspirin as a compound that can induce the gene signature needed to generate new dentine.

The QUB scientists then treated stem cells in a Petri dish with aspirin and found "genetic and also material evidence that it can produce dentine".

Image copyright Getty Images Image caption Dental decay has long been a problem in children's teeth throughout the UK

"The next step is to go and try and figure out how you are going to apply the aspirin to the teeth, to regenerate the dentine and to replace the need for fillings."

Applying the aspirin to teeth will not involve simply putting it on an infected tooth however.

"You need to put it [on the tooth] in a way that it can be easily released over a long period of time, if you put an aspirin now on a cavity, it's going to be washed away," Dr El Karim said.

"We are not encouraging that, there is a scientific way to go about this, so that we produce a final product that can be used by a dentist, not by a patient.

Image copyright Getty Images Image caption Fillings may need to be replaced many times during the lifetime of the tooth

"The next step is to work with our pharmacy colleagues to try to develop a vehicle to put it in to the teeth, after that clinical trials."

Dr El Karim said the fact that aspirin is already a licensed drug should help the development of the treatment.

"We are not really talking about 10 or 20 years time, it will probably be in the near future that it could be tried in a clinical trial with patients," she said.

"There is huge potential to change our approach to one of the biggest dental challenges we face.

"This novel approach could not only increase the long-term survival of teeth, but could also result in huge savings for the NHS and other healthcare systems worldwide." ...

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The designer who weaves clothes with her blood

If you're diabetic, checking your blood sugar level is part of the fabric of life.But one designer with the condition went a step further and wove her blood results into the fabric she designs.

Poppy Nash sitting next to her sewing machine amongst her materialsImage copyright Melanie Hyams

Poppy Nash was diagnosed with Type 1 Diabetes aged six which meant her body was no longer able to produce insulin.

"It was horrible and scary," she says, as she recalled the day her GP sent her straight to A&E."I remember Mum crying in the hospital.That's when I realised there was something wrong."

Nash was diagnosed and discharged with a new life-changing routine which revolved around injections and measuring blood-sugar levels multiple times a day, a demanding cycle kept up by her mum for many years until she was old enough to take responsibility for her own health.

When she was hospitalised at 18, after she accidentally injected herself with double the amount of insulin she needed, the true gravitas of the condition hit her.

"That was my wake-up call," she says."It was like a second diagnosis and I suddenly realised 'I'm in charge of this stuff that essentially can kill me'."

It gave Nash a new outlook when she left home for Glasgow School of Art to study Communication Design where she "pushed" her way into the textiles department to learn how to screen print.

Material designed by Poppy NashImage copyright Melanie Hyams

Asked to create a body of work on a subject she cared about, Nash says she hit a wall as the "voice" of diabetes became "too loud" and drowned out her creativity.

"I got so stressed out and my diabetes control went badly," she says."Diabetes was the thing that made me stop doing my project work so I turned the situation on its head, then it made sense."

Nash went back to her blood sugar monitor and the ream of data it automatically stores which reveals how her body reacts to life - the good and bad.

She took the numbers, sometimes elaborated on them or added colour, then printed them onto fabric, before she turned that fabric into wearable artwork and felt she was literally weaving her blood into clothes.

"When you do research for a project you have to really believe in what you're doing and this [diabetes] is the only subject that I really cared about," she says.

"It makes me weirdly happy because I feel I'm cheating something, but they're also real numbers and that's why it's so scary."

Poppy Nash sitting amongst her material designsImage copyright Melanie Hyams

Although Nash loves to focus on her work, she says it can bring on negative thoughts if she dwells on the reality of the figures and the impact the condition can have on her life.

"I was looking at these articles of people dying in their sleep from diabetes and I thought 'actually I can't do this'.

When that happens Nash says she has to put her work to one side for the day.She says "it's scary" but believes the project is ultimately good for her because it makes her confront the reality of what can happen if she doesn't look after herself.

When she's being creative in the studio Nash tries to look at her blood sugar levels artistically rather than medically.

The repetitive nature of writing out the numbers can be a "good therapy", she says, but she has to be careful not to get overwhelmed and focus only on the "bad numbers".

According to Diabetes UK, healthy blood sugar levels vary between each person but tend to be between four and nine, depending on when they have eaten - some of Nash's readings, which she has printed on her fabric, reach as high as 18.

Clothing and fabric designed by Poppy NashImage copyright Poppy Nash

Nash's latest commission is to design the interior of a house for the National Disability Arts Collection and Archive but she has also started to experiment with text to make sense of the mass of information she is meant to know about the condition.

She has started to collect news articles which reveal the harsh realities of diabetes, and use them to create patchwork quilts.

"I'll write out a whole article and then cut it up.I'll use fragments on some patchwork - one is about diabetes burnout - because it's so impersonal.It's all about people not choosing a healthy lifestyle."

Burnout can arise years after a diagnosis when, out of frustration, some people with diabetes get sick of the diet and testing regime and give up or lapse.They may disregard their blood sugar level management or switch back to unhealthy eating habits.

Alongside her own artwork Nash works as a pattern drafter and cutter and recently made costumes for a band.

Poppy Nash's artworkImage copyright NDACA

Her current focus is on textiles - fabrics, clothing and one-off pieces for exhibitions - but she hopes one day there might be a clothing collection.

"I would love people to wear them," she says, "They'd be telling the story of diabetes and they wouldn't even know."

Nash has had to overcome a lack of confidence in the worth of her artwork and whether it's relevant to non-diabetics.

"I think about diabetes all the time," she says."I worry that if I think I talk about it all the time I feel self-indulgent.But it's not only diabetics who like it and it opens up conversations."

Even with the best management, hypos - when blood sugar gets too low - can occur regularly and Nash estimates she has two a week.

"It's like tripping out," she says."You have no idea what's going on.My boyfriend has been talking to me and I just didn't understand what he was saying.I could repeat the words, but I didn't understand them.

Design for the National Disability Arts Collection & Archive commission with a table-setting covered in carbohydrate informationImage copyright Poppy Nash

"If there was a rulebook on how hypos can be caused it would be longer than Harry Potter," she says.

Nash will continue to monitor her blood sugar levels indefinitely but it will also continue to provide her with a well of creative possibilities.

"This is a nice platform, because I can turn something so rubbish into something that I like, it makes it kind of amusing.

"Diabetes as a subject can go on and on, so long as people want to listen."

If you have been affected by anything in this article you can visit Diabetes UK for further information about the condition.[1]

Ouch graphic

For more Disability News, follow BBC Ouch on Twitter[2] and Facebook[3], and subscribe to the weekly podcast....

References

  1. ^ Diabetes UK (www.diabetes.org.uk)
  2. ^ Twitter (twitter.com)
  3. ^ Facebook (www.facebook.com)

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Litigation 'threatening NHS finances' - BBC News

DoctorImage copyright Thinkstock

The rising cost of litigation is threatening the financial health of the NHS in England, auditors are warning.

The National Audit Office says the bill for clinical negligence has quadrupled in the last 10 years, reaching nearly £1.6bn last year.

It is urging the government to do more to curb the costs.

But ministers say they are taking steps, pointing out moves have been made to limit lawyer fees as well as a swifter resolution for birth injuries.

The latter tends to attract the highest damages awards because of the lifelong care that is needed in the worst cases.

But the NAO said on their own these measures would still not be enough.

It said some trusts were already spending 4% of their income on clinical negligence, which was proving too much.

And it said this could become the norm - with annual costs expected to top £3bn by 2020-21.

It pointed out there was no evidence more mistakes were being made or care was getting less safe.

Instead, the NAO said the rising costs were related to higher damages awards, higher lawyer fees and more claims.

NAO head Amyas Morse said litigation was a "significant" cost placing pressure on an "already stretched system".

And Niall Dickson of the NHS Confederation said:"We cannot go on like this.This rising tide of litigation is draining the NHS of resources and must be urgently addressed."

A Department of Health spokesman said the steps being taken would help.

But he added "there is still more to do", adding a new strategy would be developed in the future....

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Anxiety over health 'caused by cyber-chondria'

Woman in waiting area holding her chestImage copyright Getty Images Image caption Worrying excessively about health issues should be picked up and treated, researchers said

Worrying excessively about health, and going for unnecessary appointments and tests, is a growing problem - fuelled by looking up symptoms on the internet, researchers say.

Health anxiety can also be caused by previous health scares and could affect one in five hospital out-patients.

UK researchers said psychotherapy could reduce anxiety and should be on offer in all hospitals.

They are calling for official health anxiety guidelines to be drawn up.

A team including researchers from Imperial College London and King's College London said the symptoms of health anxiety were often mistaken for those of a physical illness and included chest pains and headaches that didn't go away.

Even when a doctor offered reassurance that there was no underlying physical reason for their symptoms, patients continued to worry and look for a diagnosis.

And this led to expensive and unnecessary medical appointments and investigations, as well as time off work, they said.

Prof Peter Tyrer, emeritus professor in community psychiatry at Imperial College London, said the internet had a part to play.

"We suspect that [health anxiety] is increasing in frequency because of what is now called 'cyber-chondria'.

"This is because people now go to their GPs with a whole list of things they've looked up on the internet, and the poor GP, five minutes into the consultation, has four pages of reading to do," he said.

Image copyright Getty Images Image caption Cyber-chondriac?Looking up symptoms online is one way to create anxiety over your health

"Dr Google is very informative, but he doesn't put things in the right proportion."

Prof Tyrer said patients didn't tend to pay attention to the word "rare" if they thought they had a disease.

The researchers, mostly mental health experts, said it was important to identify people with health anxiety and offer them treatment so their overall wellbeing improved.

They estimate that the problem could be costing the NHS at least £420m a year.

Useful therapy

In their study[1], published in the National Institute for Health Research journal, they found that cognitive behavioural therapy (CBT) sessions were much more effective at improving health anxiety than standard care, and the benefits lasted for up to five years.

They tracked 444 patients with severe health anxiety from five hospitals in England.

Nurses were just as good at delivering CBT as trained psychologists and doctors, the study suggested.

Prof Tyrer said official guidelines on how to treat health anxiety, from the National Institute for Health and Care Excellence (NICE), were "greatly overdue".

He said health anxiety was common in those with other physical illnesses, but was often ignored.

"So people, after apparently successful treatment of heart attacks, would interpret minor symptoms as warnings of further attacks, cut down on all their activities, create more suffering and have their lives thrown into chaos and disarray."

Mind and body

The researchers urged doctors to ask patients whether they were anxious about their health.

They said people were increasingly asked to monitor their own bodies for symptoms and diseases, and that was also fuelling health anxiety.

Prof John Chambers, consultant cardiologist at Guy's and St Thomas Hospital, said health anxiety caused repeated attendances in accident and emergency departments, GP surgeries and out-patient clinics and led to "over-investigation by clinicians".

He said they should consider a psychological explanation and a psychological intervention instead.

"These then need to take place locally and not at a site distant from the patient's presentation, so as to avoid the implied but unhelpful mind-body separation," he said.

NICE said its website featured guidance on general anxiety disorder (GAD) and panic disorder in adults[2] that could be relevant.

It said NHS England had to refer specific topics to it before it could decide whether guidance was appropriate....

References

  1. ^ In their study (www.journalslibrary.nihr.ac.uk)
  2. ^ general anxiety disorder (GAD) and panic disorder in adults (www.nice.org.uk)

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Spiral drawing test detects signs of Parkinson's

The tablet can measure writing speed and the pen measures pressure on the pageImage copyright RMIT University Image caption Computer software measures drawing speed and pen pressure to diagnose Parkinson's

A test that involves drawing a spiral on a sheet of paper could be used to diagnose early Parkinson's disease.

Australian researchers have trialled software that measures writing speed and pen pressure on the page.

Both are useful for detecting the disease, which causes shaking and muscle rigidity.

The Melbourne team said the test could be used by GPs to screen their patients after middle age and to monitor the effect of treatments.

The study[1], published in Frontiers of Neurology, involved 55 people - 27 had Parkinson's and 28 did not.

Speed of writing and pen pressure while sketching are lower among Parkinson's patients, particularly those with a severe form of the disease.

Image copyright RMIT University Image caption Treatment options are effective only when the disease is diagnosed early

In the trial, a tablet computer with special software took measurements during the drawing test and was able to distinguish those with the disease, and how severe it was.

Poonam Zham, study researcher from RMIT University, said:"Our aim was to develop an affordable and automated electronic system for early-stage diagnosis of Parkinson's disease, which could be easily used by a community doctor or nursing staff."

The system combines pen speed and pressure into one measurement, which can be used to tell how severe the disease is.

David Dexter, deputy research director at Parkinson's UK, said current tests for the disease were not able to accurately measure how advanced someone's condition was.

"This can impact on the ability to select the right people for clinical research, which is essential to develop new and better treatments for Parkinson's.

"This new test could provide a more accurate assessment by measuring a wider range of features that may be affected by Parkinson's, such as co-ordination, pressure, speed and cognitive function."

He added that the test could be a "stepping stone" to better clinical trials for Parkinson's....

References

  1. ^ The study (journal.frontiersin.org)

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