What’s the prognosis for 2014?

Despite all the cuts and controversies, steady progress in the fight against disease is on track for 2014


Well, we’ve made it through 2013, with no major epidemic threatening the world (although an outbreak of “twerking” traced back to a certain Miley Cyrus did cause a bit of a wobble). So, what’s the prognosis for 2014?

If you’ve been lucky enough to have had a relatively illness-free year, we wish you more good health in the coming year. For many people, however, health problems are an ongoing situation, and the new year may bring only more worries and woes.

It doesn’t help that the health sector in Ireland is facing cuts of more than €600 million, with Minister for Health James Reilly saying that 2014 will be a “massively challenging year”.

One of the most sickening aspects of the year just gone has been the revelation that charitable contributions were used to top up the already massive salaries of CRC executives. That and the fallout from the Savita Halappanavar case might leave many feeling that the long-term outlook for the health service is pretty grim.

But it’s not all doom and gloom on the health services front. In the HSE’s National Service Plan for 2014, the Minister has promised that despite reduced funding, the HSE will provide funding for such “vital service developments” as bicochlear implants, organ donation and transplant services, medical oncology and haemato-oncology, diabetic retinopathy, screening for bowel disease, and homecare packages to allow special needs babies to be discharged from hospital.

“My principal focus is to continue to deliver the same level of frontline services with a reduced budget while ensuring that quality and safety is not compromised in any way,” the Minister said.

The new year may also bring further progress in the fight against disease – and maybe even a few medical breakthroughs. We can’t look into our crystal ball and predict whether a cure for cancer or diabetes is in store, but we can look over the shoulders of scientists and medical researchers to see if any innovations or new treatments are coming down the track. Here are just a few dreams that may become reality in 2014.

Sugar assault
In 2014, your recommended daily intake of sugar could be cut in half, if the World Health Organisation has its way. Currently, the WHO recommends that a maximum of 10 per cent of your total energy should come from sugar. However, following studies into tooth decay, and a growing belief that sugar is a major factor in obesity and heart disease, the WHO wants to change that recommended figure down to 5 per cent or less. So I’ll just have half a spoonful on my cereal, then, please.

Superbug sandwich
Antibiotic-resistant bacteria such as Clostridium difficile have proven notoriously difficult to tackle, but scientists at the University of Leicester may have found a way to zap these superbugs – by feeding them to a supervirus. The team has isolated a number of bacteriophages – viruses that eat superbugs for breakfast – which could replace increasingly ineffective antibiotics in the battle against bad bacteria.

Following on from the research, a US biopharmaceutical company, AmpliPhi, has developed phages that target a bacteria which causes lung infections in cystic fibrosis patients, and are hoping to have a phage that deals with C difficile ready for clinical trials very soon.

Gut feelings
Separate research in two Irish universities may result in effective treatment against inflammatory bowel diseases such as Crohn’s and ulcerative colitis. At NUI Maynooth, a team of scientists led by Prof Paul Moynagh have identified a protein, Pellino3, which may prove crucial in preventing the development of Crohn’s disease.

Crohn’s is currently incurable, but Moynagh’s team is hoping to use the Pellino3 protein to create effective treatments for this chronic inflammatory disease.

Meanwhile, a team of researchers at UCD’s Conway Institute, led by Prof Cormac Taylor, has published a study showing how hydroxylase inhibitors can suppress the inflammatory response in Crohn’s disease and colitis. The next step is to develop drug treatments based on these hydroxylase inhibitors, which could negate the need for surgical removal of inflamed tissue.

A real eye-opener
Retinitis pigmentosa (RP) causes a degeneration of the delicate photoreceptor cells in the retina, leading to gradual loss of vision and eventually blindness. There may be hope for some of the 1.5 million people around the world affected by RP – a bionic eye that allows patients to detect light and dark and identify location and movement of people and objects. A video camera mounted on a pair of spectacles takes in the images and the retinal implant receives the data, which is transformed into electrical pulses which the brain then learns to interpret. While it doesn’t quite restore sight, it will allow people with severe RP to perform basic tasks, walk in public places and even in some cases discern large lettering.

Sleep mode
Some medical procedures, such as colonoscopies, can be carried out with the patient under mild sedation such as propofol rather than full anaesthesia. But a trained anaesthetist is still needed to make sure the right dose of sedation is administered, which adds to the medical bill.

The answer may be computer-assisted sedation, using a personalised sedation device to administer the exact amount of propofol without the need for an anaesthetist. Clinics and medical centres in the US are expected to begin using the system on a limited basis in early 2014 – alas, around five years too late for Michael Jackson.

Goodnight pressure ulcers

Pressure ulcers – commonly known as bedsores – affect people with limited mobility, wheelchair users and bed-ridden patients. They are painful, debilitating and difficult to treat in older people and chronically ill patients. They are also a scourge of hospitals, but this year the medical profession will be really putting the pressure on pressure ulcers. On world Stop Pressure Ulcer Day last November, a collaborative effort in Ireland to eradicate pressure ulcers was announced.

“This pressure ulcer collaborative will enable participants to collect accurate data in relation to pressure ulcers and build the collection process into their daily work,” said Prof Zena Moore of the Royal College of Surgeons in Ireland, who is on the steering group.

Who knows, 2014
may be the year when
pressure ulcers are finally put to bed.

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