Northwick Park Hospital

About: Northwick Park Hospital is a healthcare organization based out in London, United Kingdom. It is known for research contribution in the topics: Population & Blood pressure. The organization has 4387 authors who have published 4184 publications receiving 192933 citations.

Vibration exercise makes your muscles and bones stronger: fact or fiction?

Abstract: Vibration transmitted to the whole body or part of it has been extensively studied in relation to the risks to the health and safety of workers. These studies have highlighted the particular danger of lower-back morbidity and spinal trauma arising after prolonged exposure to vibration. However, short-term exposure to whole-body vibration (WBV) or the use of vibrating dumbbells can have beneficial effects on the musculoskeletal system. As a consequence of this encouraging work, many manufacturers have developed exercise devices characterized by vibrating plates transmitting vibration to the whole body and vibrating dumbbells. Preliminary results seem to recommend WBV exercise as a therapeutic alternative for preventing/reversing sarcopenia and possibly osteoporosis. However, there is a paucity of well designed studies in the elderly. In particular, there is a lack of understanding of the physiological mechanisms involved in the adaptive responses to vibration exposure, and of the most appropriate vibration parameters to be used in order to maximize gains and improve safety. The effectiveness of this novel exercise modality on musculoskeletal structures is examined in this review. The physiological mechanisms involved in the adaptive responses to vibration exercise are discussed and suggestions for future studies are made.

Treatment of relapsing Clostridium difficile diarrhoea by administration of a non-toxigenic strain.

Abstract: Two patients with relapsing Clostridium difficile diarrhoea following metronidazole and vancomycin therapy were colonised with a non-toxigenic avirulent Clostridium difficile strain given orally in three doses. Both patients appeared to respond without sideeffects. Oral bacteriotherapy with a defined nontoxigenic strain of Clostridium difficile would appear to represent an acceptable, alternative and novel way to treat hospitalised patients who relapse with Clostridium difficile diarrhoea after specific antibiotic therapy.

Population Testing for Cancer Predisposing BRCA1/BRCA2 Mutations in the Ashkenazi-Jewish Community: A Randomized Controlled Trial

Abstract: Important advances in understanding germ-line predisposition to familial cancer have led to the identification of several rare high-penetrance genes causing cancer syndromes: BRCA1/BRCA2 (familial breast and/or ovarian cancer) and mismatch-repair genes (Lynch Syndrome). BRCA1/2 carriers have a 50% to 80% risk of breast cancer, a 20% to 45% risk of ovarian cancer (OC), and a 5% to 25% risk of prostate cancer (1–5). Established management strategies for high-risk individuals include: 1) risk-reducing salpingo-oophorectomy (RRSO) to prevent tubal/ovarian cancer (hazard ratio [HR] = 0.21) (which also halves breast cancer risk in premenopausal women) (6), 2) risk-reducing mastectomy to prevent breast cancer (7–9), 3) early onset breast screening (MRI/mammograms), and 4) preimplantation genetic diagnosis. Within the UK National Health Service (NHS), genetic mutation testing is limited to individuals with cancer from high-risk families (carrier probability ≥20% in the general population and ≥10% in the Jewish population) or individuals from families with a confirmed BRCA mutation who request referral to specialist genetic clinics. This family history (FH)–based approach requires individuals/general practitioners to recognize and act on a clinically significant FH. Mutation carriers who lack/are unaware of their FH, who do not recognize the risk associated with FH or are not proactive in seeking advice, are inevitably excluded (10–12). Most of these current approach–associated limitations could be overcome by systematic population-based testing. The literature indicates that genetic counseling/testing is associated with psychological benefits in noncarriers and has no substantial adverse psychological consequences for carriers (8,13). However, available data are predominantly from trials in highly selected samples of individuals with a strong FH of cancer, and the results cannot be generalized to the general population. There is no established model for population-based testing of dominant mutations, and the best way to deliver this service on a population basis is unknown.(13) We describe results from the first phase of a novel randomized controlled trial (RCT), Genetic Cancer Prediction through Population Screening (GCaPPS). The objective was to assess the benefits/disadvantages of a population-based approach to genetic testing for high penetrance–dominant gene mutations compared with the conventional FH-based approach. The RCT design provided a basis for comparison of psychological and quality-of-life differences between population-based and FH-based testing. We based the trial in an Ashkenazi Jewish (AJ) community as a population-model and used BRCA1/2-mutations as our disease-model. These choices were guided by the higher prevalence of three BRCA1/2 founder mutations in the AJ population.