02 Feb

imageMany of you reading this will understand that feeling when you are preparing to have an annual performance appraisal. What you have done, how have you performed since your last appraisal and what you are going to do in the next year with a particular emphasis on addressing your learning needs and how you can improve patient care.

You will all be aware that in General Practise we are going through significant changes and we will have more than enough to think about regarding organisational changes. However, we all like to remind ourselves that besides this that health and ways of treating medical conditions are also changing considerably.
Last year as well as attending many meetings regarding organisational changes I attended meetings to discuss particular patients (with their consent) with other GP’s, specialists and other health care professionals how their care could be improved within primary care.
I also attended structured lectures or small seminars on specific medical problems and I decided to focus on cardiology.
By doing all this it has a significant impact on patient care in that it improves skills of diagnosing a condition, knowledge of appropriate treatment and to find a propitious time for referral.

Heart failure has been something that Dr Livingston and myself looked at and during the past year we have significantly improved our way of diagnosing much earlier and being able to refer to a cardiology outpatient clinic rather than the patient presenting in a more advanced state and needing emergency admission often in extremis.
What is heart failure?
Heart failure affects 800,000 people in the UK. It is a serious condition caused by the heart failing to pump enough blood around the body at the right pressure.
It usually occurs because the heart muscle has become too weak or stiff to work properly.
If you have heart failure it does not mean that your heart is about to stop working. It means that your heart needs some support to do its job, usually in the form of medicines.
Breathlessness, feeling very tired and ankle swelling are the main symptoms of heart failure. Living with severe heart failure is a constant fight for life. Every year, thousands more families have to watch the people they love struggle with the distressing symptoms.
The symptoms of heart failure usually develop quickly (acute heart failure), but they can also develop gradually (chronic heart failure).
It is often difficult to diagnose as it has many causes and can occur when a number of problems usually ‘gang up’ on the heart, causing it to fail.
To learn more about heart failure the following website may be helpful:-
This will also outline how patients with heart failure can adapt their lifestyle and detect early warning signs.

aBritish heart foundation. This month the British Heart Foundation has launched a research programme ‘Mending Broken Hearts’ at a critical stage in the UK in the fight against heart failure.

When you have a heart attack your heart will suffer damage that can never be repaired. In some people this can lead to heart failure, which in severe cases leaves you disabled and gasping for breath, with a life expectancy of less than five years. Oi

Living with severe heart failure is a constant fight for life. Every year, thousands more families have to watch the people they love struggle with the distressing symptoms.

Until now, there has been no hope of a cure. No way to mend a broken heart. But with recent advances in regenerative medicine, repairing a damaged heart is a realistic goal.
Mending Broken Hearts is the most ambitious research programme the BHF have ever carried out.

Researchers co-funded by the BHF have identified a molecule that tells certain stem cells in the embryo whether to become either heart muscle or blood vessel cells.
Zebra fish
The discovery – in zebrafish – tells us more about the origin of cells in the adult heart. This takes us another step closer to being able to make new heart muscle to repair the damage caused by heart attack – mending broken hearts.
Zebrafish are useful to scientists because they have a fully functioning simple heart and circulatory system. If part of their heart is removed, they can grow it back in a matter of weeks.
Intriguingly, the researchers believe that this molecule – called Fibroblast growth factor (Fgf) – is also the evolutionary switch that made complex four-chambered human hearts possible, from the two-chambered ‘tube’ we see in fish.

This provides important clues to researchers working towards the goal of mending broken hearts
The team from the University of Oxford – a BHF Centre of Research Excellence – say that during evolution a rise in Fgf levels tipped the balance so that more heart muscle was formed, meaning that the heart could become bigger and support a larger animal.
Professor Roger Patient, who led the research, said: “If we can find stem cells in the adult human heart that have the potential to form heart muscle and blood vessels, we may be able to manipulate this Fgf switch and create brand new heart muscle. This could bring significant benefit to heart attack patients or people with heart defects. At the very least, our research will help the production of these cells in the laboratory for use in heart repair.
Scientists have found another fish with similar powers and hope to harness it to help us mend broken hearts.
An amazing species of fish – called Astyanax mexicanus – could help scientists come up with a way to mend broken hearts damaged by heart attack.
Research at University College London, led by Dr Yoshiyuki Yamamoto and Dr Mathila Mommersteeg is now being funded by the British Heart Foundation. These top scientists are interested in this fish, a close relative of the zebrafish, because it has the amazing ability to regenerate its heart tissue after damage. What’s unusual about Astyanax mexicanus is that it exists in two forms – sighted fish that live in rivers, and blind cavefish.
Despite being the same species, the river-dwelling fish can regenerate its heart tissue after damage – the cavefish cannot. Scientists want to understand the differences between these fish so they can learn more about what allows the river fish to mend its own heart.
Research like this helps provide clues towards finding a cure for heart failure.
Next time you visit The British Heart Foundation shops in West Ealing to either purchase or donate furniture or other items which they will collect free of charge you will be donating towards this important research.

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Posted by on February 2, 2014 in Training and Advice


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