Mending broken hearts with…..

I took part in the Nottingham summer school, which was a great week to know a bit more about medicine. I have been interested in heart mechanisms so when a talk about “mending broken hearts” was introduced, I went on to researching a bit about this. I found that a fish species known as zebrafish (native to South Asia ) are a significant model in the regenerative biology of hearts and in particular the fixing of “broken hearts”. I know, quite intriguing right?

The zebrafish has characteristics, which makes it a “smart model” for the study of hearts. Zebrafish can repair its damaged heart in a matter of weeks whereas in humans this is very unlikely. The most intriguing characteristic, which is probably also the most important, is that the zebrafish is transparent in its early life cycle. Therefore, researchers are able to see the blood vessels and heart itself grow, which would be fascinating to see I’m sure. Due to their heart being able to develop just 12 hours after birth, the researchers are provided with quick results, making it advantageous for their research. The heart starts out as one long tube and then twists and folds to become the shape we recognise. A consultant cardiologist suggested that switching of particular genes in the zebrafish to identify how blood vessels regrow and repair, will help to identify the genes responsible for the mending of the broken heart. Using the same idea, the possibility of switching the right genes in humans would mean a higher chance of surviving a heart attack ,for example. Zebrafish allow a wide range of genetic manipulation and provided that there are fewer ethical restrictions to mammalian models, they are increasingly being used for research in biology.

To fully regenerate the heart, the zebrafish leaves a temporary scar due to new cardiac muscle cells being formed. Despite having anatomical differences between humans and fish species, the aspect of being vertebrates and having similar cellular structure allow information to be extrapolated by scientists.  Zebrafish embryos that lacked blood circulation, are still supplied with oxygen as they reach all tissues due to passive diffusion as the embryo is so small. This is where for humans this is completely different as the narrowing of arteries due to fatty deposits leads to insufficient blood being supplied. Heart attacks are normally treated with intervention and catheterised procedures, which involves balloon angioplasty and inserting stents to keep narrow arteries open.

Therefore, the introduction of the zebrafish into the development of research to improve “broken hearts” is fascinating. The burden of cardiovascular diseases is staggering and so the developing research into these fish species may be extremely beneficial for future cardiologists!

Robotics in healthcare

The endless challenges of getting accepted into medical school and graduating to become a doctor is something relatable to all doctors. So the introduction of robotics have both pros and cons, considering they will have a shocking influence on the medical sector in the future.

Even though, introducing robotics into hospitals etc. would be very new to both patients and all healthcare staff themselves, they would increase the productivity of doctors. Doctors could save more than half their time in diagnosing, monitoring patients, prescribing medication. This would be especially more helpful due to the overwhelming number of patients in hospitals and GP’s. Surgeries and operations would be less time consuming so majority of the strain and stress doctors experience would be off their shoulders. Considering this situation, this has an immense knock on effect on the whole medical sector. For example, more patients can be treated per day, which means there are an increased number of spaces for patients most in need.

I watched a short clip about robotic surgery, which fascinated me as to how robots can be used in order to perform surgery in a much shorter time. The surgeons use a console to control the robot and handles are used to make movements, which a robot would mirror. Robots can identify hard to reach areas, which are difficult to perform by the human hand. Therefore, there is improved vision, instrumental control and dexterity, which results in less pain for patients and quicker recovery time.

However, many are in doubt whether the development of robotics will lead to decreasing the healthcare roles and jobs. Importantly, it is extremely expensive to use robotics and it is unlikely a robot can replace the basic doctor- patient relationship. The emergence of robotics in healthcare is not new as the in 1999 the da Vinci surgical system which became one of the first robotic-assisted surgical systems to gain clearance. It has been benficial ; for example, one outcome is reducing the number of complications associated with hysterectomy for benign conditions.

Therefore, the fast development which will be seen in the healthcare sector soon will lead to many changes that will hopefully be helpful for doctors to manage complication with patients and the healthcare sector overall.

Privatisation of the NHS

Doctors aim for the best NHS service however, privatisation of the NHS, which became a topical issue, is still quite controversial. There is an issue that privatisation is leading to undermining the NHS core values. Privatisation of the NHS is when the role of the government is reduced and increasing the role of the private sector. I came across this topic and decided to find the pros and cons of it as it could be affecting the NHS hugely in the coming years.

The core values of the NHS are being imapcted , for example, from an article from the “week newsletter” it states that the elderly will experience issues with the continuity of the doctors, which affects the trust and confidence they have. Considering that the NHS prioritises a good doctor-patient relationship, I think it would be unfair for the elderly to experience such issues. This is particularly important, as they may feel distressed that they have to discuss issues with different doctors.  In addition, instead of common medicine becoming more affordable, prices are increasing which puts patients in a further stressful situation.

It is estimated that 7% to 22% of the healthcare budget goes to private providers, so when the NHS is already spending majority of their budget on elderly medicine due to multi-morbidity, I think that gradually there will be a financial struggle.

However, it is also stated that privatised sectors allow patients to choose where they can be treated and also their treatment , which supports autonomy. Also, the NHS is becoming over reliant on private sectors due to their overwhelming number of patients; for example one quarter of NHS knee replacements are performed by private providers. So , even though privatisation can help with the increased demand for the NHS it is starting to impact the core values it holds.

Congenital heart defects

So, I was searching through many articles and videos about cardiovascular diseases and came across this documentary on congenital heart defects (CHD) . CHD are known to be the first birth defect and of which majority of the time the cause is not known. This surprised me, as cardiologists would find it much more difficult than it already is, to know how to diagnose or prevent it in the future.

Congenital heart defects (CHD) is the defect when the heart is underdeveloped, so enough blood is not supplied to the heart muscle, or when the valves have not formed properly when the baby is in the mother’s womb (pre-birth).

The fact that CHD can sometimes be undetected throughout an individual’s whole life is something I found extremely shocking as this defect has a life-changing impact on one’s life. CHD’s can be detected by heart murmurs, where unusual sounds are heard between heartbeats. In infants, this is usually known as an innocent murmur .A symptom when the baby is born is cyanosis (being blue in colour) because of the limited blood flow and this is more subtle in infants of darker and black ethnicities. A pulse oximeter probe is therefore used and in this time period where “black lives matter” is an important topic, it is crucial for everyone to know how to detect these defects in darker minorities.

Fetal intervention is being used to correct forms of CHD before birth and due to the research from the year 2000 onwards, treatments to congenital heart defects are being found. They include heart transplants, surgery and catheter procedures depending on age and severity. During this current pandemic, where deaths are increasingly mounting up I think that the technological advancements to assist with such heart defects are such an advantage.

Start of my journey!

Even though this quarantine has been a tough time, I guess it’s also a new learning experience. However, I had some time to think about why studying medicine is for me. Through an amount of online resources such as a virtual work experience, the fact that medicine requires great responsibility, as we all know, was really emphasised. But this allowed me to gain a deeper insight into what medicine really consisted of. So I guess, this summer holiday is going to be one with a great deal of researching and exploring to do. To be honest, the road to medicine will be a long and bumpy one but with a determined mindset I aim to  complete this journey successfully .

I am interested in cardiovascular diseases and other serious conditions, which are increasingly affecting the society today so expect blogs on related issues!