Vietnam and Laos

Recalling the 'Legionnaires' Disease' post back in February, it was reported that "the total number of confirmed cases is 52, while the number of suspected cases is at 48" (http://tinyurl.com/7tebrer) in Edinburgh.

I am travelling to Vietnam and Laos for a month with my school and thought I would look into two of the illnesses that can be caught from spending time in these countries (Japanese Encephalitis and Rabies).

Japanese Encephalitis. This "can be a serious illness causing inflammation of the brain, caused by a virus" (http://tinyurl.com/dys8sc7) and is transmitted by "the bite of infected mosquitoes, not transmitted between humans" (http://tinyurl.com/dys8sc7). The vaccine is recommended for travelling to East Asia as can be seen on this map http://emedicine.medscape.com/article/233802-overview which shows the predominant area where it occurs (there is also more information about the virrus itself on this website.

I mentioned that it 'can be serious' and this is because it is "usually a mild illness with no symptoms, only around 1 in 200 having the serious illness" (http://tinyurl.com/dys8sc7) where  "encephalitis (inflammation of the brain) occurs. This can cause permanent brain damage and is fatal in some cases" (http://tinyurl.com/dys8sc7).

Rabies. As most of you know it is passed on from the bite or scratch of an animal infected with the rabies virus. "The virus passes through the cut skin and travels (gradually) into the nervous system. It causes spasms, fear of water, madness, paralysis and usually death" (http://tinyurl.com/d6bw8n4). It is therefore a very serious illness, just like Japanese Encephalitis in the cases where it does cause encephalitis. To immunise yourself from rabies there is a series of injections which "stimulate your body to make antibodies against the rabies virus" (http://tinyurl.com/d6bw8n4). If you are bitten then it is recommended that you "clean the wound thoroughly and seek medical help" with "symptoms usually starting 2-8 weeks after however, symptoms may occur months or even years after" (http://tinyurl.com/d6bw8n4).

Both of these illnesses are serious and are worth considering for immunisation before travelling, especially if travelling to the areas where they occur, such as South East Asia. Whatever the illness or wherever you are travelling you should always research the diseases/illnesses from that country so that you can go to your doctor with an idea of the immunisations you will need to have/discuss having. A very good website for finding out about illnesses is http://www.patient.co.uk/.

As I am away for a month this will be the last before I get back but I have work experience on the two days after I get back so will update you then.

EuroSCORE

EuroSCORE stands for "European System for Cardiac Operative Risk Evaluation" (http://www.euroscore.org/what_is_euroscore.htm) and it is used in cardiac surgical theatres for "calculating predicted operative mortality for patients undergoing cardiac surgery" thus "a good measure of quality of cardiac surgical care" (http://www.euroscore.org/what_is_euroscore.htm). Effectively it calculates the risk of survival/death of the patient undertaking a cardiac operation based on 17 items of information in three categories "patient-related, cardiac-related and operation-related factors" (http://www.euroscore.org/euroscore_scoring.htm). These are then all taken into account and a formula is used (http://www.euroscore.org/logisticEuroSCORE.htm) to calculate the EuroSCORE for the patient.

All of the factors contribute to a final score/percentage chance of death and is used in a huge number of hospitals across the UK and Europe.

The data used to calculate the score was developed from studying "nearly 20 thousand consecutive patients from 128 hospitals in eight European countries. Information was collected on 97 risk factors in all the patients. The outcome (survival or death) was related to the preoperative risk factors. The most important, reliable and objective risk factors were then used to prepare a scoring system" (http://www.euroscore.org/what_is_euroscore.htm); which is a huge number of people and body of risk factors to develop a scoring system based on a patients risk relative to what has happened in the past.

News Bias

"Can spending less time sitting down add years to your life?"

The first paragraph of this BBC report (http://www.bbc.co.uk/news/health-18767278) on whether spending time sitting down actually increases your risk of death or not appears misleading to the research that has actually been produced. They say "limiting the time we spend sitting to just three hours a day could add an extra two years to our life expectancy." The key word in this sentence is the word 'could'. Later in the report it is reported that "experts say the US estimates are too unreliable to predict personal risk" and even that "the researchers themselves acknowledge there are flaws that make its findings less than reliable." So why have the BBC published this report and why do other news corporations publish research in their papers/websites that doesn't appear to give a conclusion? For example, I found another website that published this story but had a completely different angle that seemed to suggest it was firm. The website (http://tinyurl.com/bmbwxot) did not publish anything about the fact that the research may have had flaws and only suggested that it was unreliable was when they stated "they used the data to extrapolate the effects of sitting down on the health of an entire population" but to the eye of someone who doesn't understand the term extrapolation in terms of data this would mean nothing and would presume that the data was in fact reliable.

But why would 'Healthcare Today' take to the side of the argument that the data is reliable? What is their motive for giving a bias to the data? Going to the root of the data, the actual paper itself from BMJOpen, I found that Dr Peter Katzmarzyk, the man who conducted the research, came to the conclusion that "reducing sedentary behaviours such as sitting and television viewing may have the potential to increase life expectancy in the USA" (http://tinyurl.com/d4jlx8w) and that the rise in life expectancy is in the bounds of "1.39 and 2.69 years for sitting and 0.48 and 2.51 years for television viewing" (as above). This is a published piece of research and it is now the job of other scientists to research this further and test the conclusions of Dr Katzmarzyk, so in the future we will see the validity of the data.

But the point I was trying to illustrate was that you should never take the first news story you see as truth, always try to get opinion from lots of news corporations to account for all of the sides of the story that they are trying to portray. This means that you can build a picture of the story and the different angles to it. The best items to read would be the paper itself so that you get the pure data and can draw your own opinion. I learnt this by reading a book called 'Bad Science' by Ben Goldacre who shows how to get past the media angle and at the data and opinions that are valued in the science community i.e. leading researchers/scientists.