Inside Health

Ovarian cancer is known as the silent killer - because its symptoms can often be vague - bloating, abdominal discomfort and feeling full after eating. An American medical body says that screening all women for this cancer does not save lives - and may cause more harm than good. The US Preventive Services Task Force were responding to the latest results from the PLCO study - which included 80,000 women over 55. There was no difference in outcome between the women who were offered screening and those who just carried on as normal. Around a thousand of the women who were screened had surgery after testing positive - only to find they didn't have cancer. And 1 in 7 of them had at least one serious complication following their unnecessary surgery. Professor Usha Menon from University College London says that screening could be used in women with abdominal symptoms to help spot the cancer. One Inside Health listener got in touch about his risk of developing cardiovascular disease - after his GP based his risk on his very high blood pressure reading - despite the fact that he's managed to reduce it by taking medication and exercising more. Dr Margaret McCartney says that charts in the the British National Formulary's charts are often used to assess these risks - but that other resources like QRISK can be used instead. A niggling dry cough or a constant feeling like you need to clear your throat may have been diagnosed as a post-nasal drip. But cough expert Professor Alyn Morice says many people plagued by these symptoms are in fact affected by a "leaky" valve at the top of their stomach - creating a mist of partly-digested food which triggers the cough reflex. The benefits of a vegetarian diet are often publicised - but how much does not eating meat improve your health? Dr Kamran Abbassi searches the medical literature and finds that there are modest benefits to cardiovascular risk, blood pressure and Body Mass Index. For parents who may be anxious when their children announce they want to turn veggie - one Vietnamese study found no difference between the growth rates of vegetarian and meat-eating children. Another listener Georgina Abrahams emailed to ask about treating gallstones. Does the gallbladder need to be removed surgically or can dietary changes help to alleviate symptoms? At least 1 in 10 of us will develop gallstones at some stage. Professor Hugh Barr is an upper gastrointestinal specialist in Gloucester. He explains how a low fat diet can help to prevent gallstones - which are usually deposits of cholesterol - but that once they're causing symptoms surgery is the most effective solution.

Dr Mark Porter dispels myths about osteoarthritis. It is usually put down to ageing and the result of wear and tear with people told that the condition inevitably leads to surgery. Mark Porter investigates the latest research on the condition and discovers that a third of patients will get better through the natural repair process.

HIV testing The first over-the-counter DIY testing kit for HIV is expected to go on sale in America in the next month. It's said to allow people to screen potential sexual partners for HIV before deciding to have sex them - all in the comfort of their own home. But sexual health consultant from London's Chelsea and Westminster hospital Ann Sullivan believes that the idea is flawed as someone could be recently infected and still show a negative result. Her hospital offers an HIV test to all patients who are admitted to the Emergency Department. A positive result is picked up in around 4 people in every thousand tested. Glasgow GP Dr Margaret McCartney analyses the latest HIV figures for the UK - which are on the rise. She advises that safe sex should be practised even with a negative result to help protect people from all sexually transmitted infections. Vitamin D and TB As much of the UK enjoys the last of the summer sun, Vitamin D is back in the headlines. The body makes its own Vitamin D with sun exposure - but supplements in tablet form can be taken by anyone who's deficient. A dose of the Vitamin D was given to patients with tuberculosis - along with the regular antibiotics - and it helped to speed up their recovery. Dr Adrian Martineau, who's a Senior Lecturer in Respiratory Infection and Immunity at Queen Mary University, London, says that the Victorian idea of giving "consumptive" patients of sunshine was spot on. Vitamin B12 A growing number of people believe they're deficient in another Vitamin - B12. Sources of the vitamin include meat, fish and dairy products - so strict vegans can be at risk of deficiency. The vitamin is crucial in the production of red blood red cells and for the normal functioning of the brain and nervous tissue. Symptoms of low levels can include anaemia, tiredness, pins and needles, memory loss and confusion. If it's not addressed promptly the damage can be irreversible. John Hunter who's Professor of Medicine at Cranfield University sees many patients who can't absorb the vitamin because of problems with their gut like Crohn's or Coeliac disease. Another condition - pernicious anaemia - is caused by the lack of a protein required to make absorption possible. As many as 1 in 30 adults have B12 deficiency - rising to 1 in 16 in the over 65s. A blood test which is used to check levels is thought by many doctors and patients to be inaccurate. The top-up injections of B12 are usually given every 2 or 3 months, in spite of many patients saying that their symptoms return well before their next one is due. Martyn Hooper from the Pernicious Anaemia Society says that testing and treatments need to be improved - to stop patients resorting to their own drastic solutions outside mainstream medicine.Mouth Ulcers One in 5 of the UK population will get mouth ulcers at some stage of their lives. For some, they can recur every month or so - in painful crops that can take a fortnight to heal. Some are associated with underlying problems such as inflammatory bowel disease, or vitamin and mineral deficiencies, but in many cases no cause is found. Patients like Ruth have to avoid certain foods - like chocolate and fruit - to reduce the risk of recurrence. She's had ulcers since her teens and now takes immunosuppressant drugs to reduce their impact on her life. Tim Hodgson who's a consultant in oral medicine at the Eastman Dental Institute in London has had some success treating them with drugs like thalidomide. He says that some patients fear that their recurrent ulcers could develop into oral cancer - but that simply isn't the case.

As many as 2 million people in the UK may have been misdiagnosed with high blood pressure - getting treatment they don't need. But how many of them have so-called "white coat hypertension" - where their blood pressure shoots up at the very sight of their doctor or nurse? For patients with high readings in the surgery doctors can offer "ambulatory" machines for them to take home, which monitor blood pressure round-the-clock. Bryan Williams who's professor of medicine at University College, London, led the team which drew up the latest blood pressure guidelines for the National Institute for Health and Clinical Excellence, or NICE. He says that anyone considering monitoring their own blood pressure at home should take measurements both in the morning and evening whilst sitting down - and work out the average over four days. The British Hypertension Society has a list of approved home blood pressure monitors on their website.NICE has also just approved the use of Botox injections to help people with chronic migraine that hasn't responded to other treatments. But it's been a controversial decision - Botox is expensive, and no miracle cure. It was initially rejected and is still not endorsed by NICE's equivalent in Scotland. Consultant neurologist Dr Fayyaz Ahmad has had some success with patients at his private clinic outside Hull. One of them is Dawn Cook, who's just had her third round of injections. She's suffered from headaches since she was 7 years old.Would you like to read your medical notes? The Government has pledged that everyone will have online access to NHS records by October 2015. So will this change the way doctors write about their patients? Professor Steve Field - who's Chair of the NHS Future Forum and one of the driving forces behind the plan - hopes that it will mean more plain English that's easy to understand. His own surgery will give patients online access early next year.One in 4 women develop fibroids at some time - benign, non cancerous growths in the wall of the uterus which can cause heavy painful periods. Surgery might be suggested to help wtih the discomfort - using keyhole techniques via the abdomen or vagina - a procedure known as myomectomy. But in recent years some less invasive techniques have become available to help relieve symptoms.

Dr Mark Porter asks whether doctors can try too hard in the early detection of disease and investigates the overdiagnosis of hypertension. This week he discovers that as many as 3 million people who have been told they have high blood pressure may not actually have it - could you be one of them?

Dr Mark Porter finds out that some medical conditions are over-diagnosed and therefore over-treated, because of the results of certain tests.

Apart from a few cases that hit the headlines, the use of anabolic steroids is rare among the athletes in the Olympic village. But in the wider society abuse has exploded, according to an expert from Liverpool John Moores University. Jim McVeigh - who's Deputy Director at the Centre for Public Health - says that anabolic steroid abusers are the largest group using needle exchanges. Anabolic steroids are naturally occurring hormones, like testosterone, which influence growth, physical development and the workings of the reproductive system. Abuse allows athletes to train harder for longer so they become bigger, stronger and faster. But those effects will not be seen if you don't exercise or fail to eat and sleep properly. The injected steroids are often combined with tablets. There are a number of side effects like a growth in breast tissue, acne, baldness and shrinking testes - as well as longer-term health concerns for the heart and kidneys. Although they share the same umbrella term - steroids - anabolic steroids are not the same as drugs from the corticosteroid family - found in cortisone joint injections and some types of creams for eczema, sprays for hayfever and inhalers for asthma. For the best chance of good recovery from strokes patients need to be treated within a few hours. In the Lake District new technology is giving suspected stroke patients access to specialists - using high speed broadband and video cameras. Dr Paul Davies is Consultant Stroke physician at the Cumberland Infirmary in Carlisle. He can assess a patient's scans and other tests over a video connection - with the help of nurses and doctors treating them locally. Thrombolytic - or clotbusting treatment - can be given if the stroke is one of the 80% caused by a clot. It's important to get this diagnosis right as the other 20% are the result of a bleed - which could be potentially fatal if thrombolysis is given. It's has been dubbed the Killing Season by some sections of the media - but Dr Margaret McCartney believes that August isn't as risky a time to be in hospital as the headlines claim. One study compared the number of deaths at the end of July and the beginning of August - but the difference wasn't statistically significant and could have been down to chance rather than a real harmful effect of new doctors.Inside Health listener and keen pianist Roger emailed the programme about Dupuytren's contracture - where the fingers curve into the hand and can't be straightened. A new treatment is becoming available on the NHS for this common problem which affects 1 in 10 people's hands. The only option used to be surgery but Mike Hayton, who's a Consultant Orthopaedic Hand Surgeon at Wrightington Hospital in Lancashire, is now carrying out collagenase injections on some of his patients. Up to 60% of Dupuytrens patients can benefit from the treatment - which helps to break down the collagen-rich cords so they can then be snapped a day or two later.

If you believe recent headlines the growing increase in deaths from liver disease is entirely down to excessive alcohol consumption, but it's estimated that two thirds of liver related deaths are caused by other conditions. Dr Mark Porter investigates two liver conditions that do not hit the headlines but could be silently creeping up on millions of people in the UK.

Do you have trouble getting an appointment to see your GP? If so, you are not alone. A Department of Health review from 2009 suggested that as many as 200,000 patients a day struggle to get a consultation with their doctor. And a quarter of those who want to book an appointment in advance simply can't. One Inside Health listener emailed us to ask why some surgeries seem to only release appointments on the day - a bit of a telephone lottery - and others do allow for some advance booking. Chair of the the Royal College of General Practitioners Dr Clare Gerada offers some insight. Monitoring patients in their own homes - telehealth - is one of the latest developments in general practice. The government hopes that the technology will help at least 2 million people over the next 5 years, saving the NHS more than a billion pounds. The £2,000 black boxes measure blood pressure, blood sugar levels and blood oxygen - information that's then sent over the internet to a medical professional. But the project to monitor patients with long term conditions like diabetes, heart failure and breathing difficulties hasn't got off to a good start and GP Margaret McCartney questions whether it will ever live up to the hype. The most seriously ill patients in hospital are looked after in Intensive Care - where they are given life-saving treatment and support with vital bodily functions like breathing. To help staff relieve anxiety - and enable staff to carry out procedures like inserting breathing tubes - patients are often sedated. Dr Chris Danbury from the Royal Berkshire hospital in Reading says it's important to get the level of sedation right - not too little and not too much. One consequence of the drugs and environment can be hallucinations and flashbacks - with some patients reporting dreams of being abducted by alien space ships. Specialist outreach nurses in Reading - like Sister Melanie Gager - are skilled at offering strategies to overcome this - including follow-up visits to the ICU for both patients and their families. Now that summer has finally arrived for most parts of the UK, if you are planning an outdoor swim then there may be hazards lurking in the water. Heavy downpours result in the release of sewage into the sea from overflow pipes - which can affect water quality for a couple of days. Inside Health reporter Anna Lacey met Pollution Control Manager Dr Robert Kierle on the banks of the river Axe in Weston-Super-Mare - and Surfers Against Sewage who are offering a free text service to alert would-be bathers about local measurements of any pollutants.

Whooping cough is on the rise - but the official figures could be the tip of the iceberg, according to one doctor. Retired GP from Nottinghamshire Dr Doug Jenkinson has spent most of his professional life researching the condition which is also known as pertussis. He says that instead of around 1,700 cases every year, there could be tens of thousands. He personally has seen around 700 cases and a blood test available for the last few years has helped to confirm cases. The key to diagnosis is a cough which almost causes choking - sometimes with the characteristic whooping sound - which then subsides for a few hours. The cough can last up to 3 months. The cough can be dangerous for infants under the age of one - who can catch it from parents and grandparents. Dr Jenkinson suggests a vaccine booster could be offered to parents-to-be.Following the recent high profile cases of elite sportspeople collapsing with undiagnosed heart conditions should screening be made available to amateurs? Since the collapse of footballer Fabrice Muamba on the pitch earlier this year the profile of so-called silent heart conditions has risen. Sanjay Sharma is Professor of Cardiology at St George's Hospital - he works closely with the charity Cardiac Risk in the Young or CRY - and supports screening. CRY believes that screening will pick up an abnormality in as many as 1 in 300 youngsters - although it freely admits that the vast majority of these would never have gone on to develop a serious problem. And it is the resulting disruption to these children's lives that puts some people off screening, not least because they far outnumber those likely to be saved by the tests. Dr Anne Mackie is the Director of Programmes for the UK National Screening Committee. She says that she wouldn't even opt for screening for her own children Following last week's feature on unfounded rumours that toys were to be banned from GP waiting rooms to reduce the risk of cross infection, an Inside Health listener emailed the programme to ask about the evidence behind products marketed as killing germs on the various surfaces we touch at home. So what's the science behind adding antibacterial agents to household products? Dr Kamran Abbasi, Editor of the Journal of the Royal Society of Medicine reveals that there is no evidence to show that products labelled 'antibacterial' reduce the number of infections in the home any more than 'regular' cleaning products. GP Margaret McCartney explains why she thinks the latest campaign to encourage more self-care for minor ailments is wrong to imply that people who consult their doctor about dandruff are wasting NHS resources. The NHS 'Choose Well Summer' campaign says 'self care is the best option if you have a summer health complaint' and it's supported by the National Association for Patient Participation, who say it's all about 'empowering individuals'. The campaign was launched with headlines about the 40,000 visits in a year to GPs which were for dandruff. But what was really behind those consultations? And how good are we at looking after our own health?Computer games are being used to help people recover from strokes and brain injury, thanks to experts in Reading. Products like Microsoft's Xbox Kinect - which can recognise a player's movements - are being adapted by Professor Malcolm Sperrin at the Royal Berkshire Hospital. The technology allows patients to select an activity - from dancing to golf or ten pin bowling - and monitor their progress as part of their recovery. The charity Headway - which supports people with brain injury - is using the technology in the community to help people to recover at home.

Dr Mark Porter debates whether the recent lung cancer awareness campaign on TV, radio and the internet, hits the spot or is scaremongering. He discovers new research suggesting some people with exercise induced asthma are being given the wrong diagnosis and treatment. And GP Margaret McCartney investigates rumours this week that children's toys are to be thrown out of the doctors surgery in the on going battle against infection.Producer: Erika Wright.

50,000 people end up in hospital every year in the UK because of bleeding from the top end of the gut - an upper gastrointestinal bleed. Around 1 in 10 of them will die. Gastrointestinal or GI bleeds are often due to ulcers - a side effect of taking aspirin and other non-steroidal anti-inflammatory drugs like ibuprofen and diclofenac. The bleeding can occur in the gullet, stomach or the first part of the intestine, the duodenum. Other causes include cancers and liver disease. The location of the bleed can be pinpointed by using an endoscope - a camera to look inside the gut - and treatments include stopping the bleeding with clips, heat or injections of adrenalin. The National Institute for Health and Clinical Excellence hopes to change that with new guidelines on managing GI bleeds - guidelines which, as of last month, hospitals in England, Wales and Northern Ireland will be expected to follow. Scotland has had similar guidance in place for the last few years. David Patch is a Consultant Hepatologist at the Royal Free Hospital in London and has a special interest in this type of bleeding. He says that patients whose needs cannot be met at smaller hospitals should be transferred to specialist units where they can be treated promptly. Tariq Iqbal who's a consultant gastroenterologist at the University of Birmingham is evaluating a new kind of treatment called Hemospray. This is a powder that can sprayed over the bleeding area to stop or slow any bleeding by accelerating the natural clotting process. New research appears to show that standing at work for long periods in pregnancy can affect the unborn child. Research in the journal Occupational and Environmental Medicine, followed 4,680 mothers throughout their pregnancies. Some of the women had jobs where they were on their feet a lot - such as hairdressing, sales and working with toddlers. Women who stood for a long time had babies with smaller heads. It's thought that standing for long periods of time causes blood to "pool" in the legs, limiting the blood supply to the rest of the body including the uterus and therefore the developing foetus. The study also showed that working up to 36 weeks of pregnancy had no impact on birth weight, size or prematurity. Previous studies have shown that heavy lifting increased the risk of babies being born early - but this study showed no such link. Many people with pain and stiffness in the shoulder are told they have a frozen shoulder. But the label is often incorrect as a truly frozen shoulder means restricted movement in all directions, accompanied by pain. It's not known what causes it but it is commoner in people with diabetes. During the very painful initial phase it's best to rest the shoulder and use analgesia to help relieve the pain, especially at night time when it can be at its worst. TENS and acupuncture can help sometimes. The tissues in the shoulder "capsule" appear to be thickened and rubbery - and some relief can be gained from surgery, to let the shoulder move more freely. If left alone about half of patients still have discomfort after 7 years - so the common belief that it lasts 2 years is a myth. As the pain starts to recede physiotherapy can be helpful and if there is inflammation - eg with calcified tendonitis - then steroid injections can relieve pain. Producer: Paula McGrath.

In Inside Health, Mark Porter clarifies recent headlines claiming that researchers have found a "Blood test that identifies depression". It certainly isn't that simple. GP Margaret McCartney reports from Paisley Abbey in Glasgow on the health benefits of joining a choir.And do special muscle building drinks live up to the marketing hype? Max Pemberton looks at the science behind the recent explosion in sales of high protein sports drinks.Plus a new treatment for helping people with fluid retention due to heart failure, that can transform a puffy face to a chiselled jaw bone overnight.Producer: Erika Wright.

Whooping cough is making a comeback - the latest figures show that there were more confirmed cases in the first 3 months of this year than there were in the whole of 2010. But the condition can only be monitored properly if GPs test for it - and it's estimated that up to 40% of persistent coughs in children could actually be down to whooping cough. Kamran Abassi who's Editor of the Journal of the Royal Society of Medicine, explains how immunity wears off as we get older. The coughing can last for up to 3 months and is most serious in small babies. Up to 10 deaths are reported each year in the UK and antibiotics can be used to treat it. In the UK all deaths in pregnancy and childbirth are recorded. Just 1 in 10,000 British women currently die - on average one woman every week. The information is held by the Maternal and Newborn Clinical Outcomes Review Programme - known as the Confidential Enquiry. Last year this clinical audit was effectively suspended after the process was put out to tender. Susan Bewley who's Professor of Complex Obstetrics at King's College, London explains why it's so important to keep such detailed information. Blushing can become a vicious cycle - with those severely affected finding it impossible to lead a normal life. Some turn to psychological therapies. Dr Jennifer Wild from the Centre for Anxiety Disorders and Trauma in Oxford says she sees a success rate of 90% in patients who opt for cognitive behavioural therapy. An operation called a sympathectomy - where the nerves are cut - can be carried out by surgeons like Alan Cameron, who works in Ipswich. He sees mixed results - with many experiencing side effects like increased sweating and sensitivity to light and sound. Dr Margaret McCartney doesn't like it when doctors use euphemisms for our genitals. Children often use words like "twinkle" or "pee pee" instead of the correct anatomical terms. But whose blushes are they sparing - theirs or their parents? An Inside Health listener emailed the programme to find out about what happens to the food he he eats - specifically how quickly peas pass through his gut into the loo. Neuro-gastroenterologist Anton Emmanuel from University College Hospital, London, demystifies gut transit times.

Dr Mark Porter goes on a weekly quest to demystify the health issues that perplex us.Professor Jeremy Pearson, Associate Medical Director of the British Heart Foundation, discusses with Mark new research that suggests that giving heart attack victims drugs to ease their chest pain could hamper the heart's ability to heal itself. The standard approach to appendicitis is to remove the inflamed organ. But a new review argues that antibiotics could be an alternative to surgery in some cases. Dileep Lobo, Professor of Gastrointestinal Surgery at the University of Nottingham, explains his team's findings. GP Margaret McCartney is on her soapbox about sick notes, following regulatory pressure from Europe that could allow people who fall ill on holiday getting compensatory time off work.Dr Kamran Abbasi, Editor of the Journal of the Royal Society of Medicine, looks into the evidence that the change from sick notes to fit notes two years ago has had an impact on people returning to work. Mark visits the pathology laboratories at St Thomas' Hospital in London to find out from Senior Biomedical Scientist Diane Murley how blood is analysed. And Dr Andrew Moore from the Pain Research Unit at the Churchill Hospital in Oxford talks about which over the counter painkillers are likely to work best for acute pain. Producer: Deborah Cohen.

Should prescriptions be free for everyone? They already are in Wales, Northern Ireland and Scotland - so why aren't they in England? The BMA says the current list of exemptions is unfair and outdated - but there are no government plans to scrap the charges for the 10% of people who have to pay for them. And as the vaccination campaign for young girls against the virus which causes cervical cancer and genital warts gains momentum - are boys losing out? Uptake of the vaccine among teenage girls in the UK is high - but there are no plans to extend the programme to boys - despite plans to do so in Australia and the United States. There are confusing statistics surrounding the debate over the use of bicycle helmets for both adults and children. Some research points to helmets encouraging car drivers to give cyclists less space in traffic. Up to a third of children in another study said wearing a helmet would put them off cycling in the first place - bad news for parents concerned about childhood obesity. GP Margaret McCartney uses her own risk analysis to work out how to keep herself safe and fit. Producer: Paula McGrath.

Aspirin is over 100 years old, but doctors still can't agree whether the benefits of taking it to prevent heart conditions or cancer outweigh the risks.Dr Mark Porter investigates. And - you've worked flat out to get on holiday, then come down with a stinking cold - is there any science behind why so many of us get sick on vacation. Plus ADHD - not in children, but ADULTS - why is it so hard for grown-ups to get a diagnosis. Producer: Erika Wright.

Dr Mark Porter demystifies discusses polycystic ovary syndrome, the health benefits of garlic, the PSA test for prostate cancer, and concerns over patients' dignity.

A new study shows that a diet rich in red meat increases the risk of developing bowel cancer - so how much is too much? Professor Tom Sanders from Kings College, London, explains how a rise in obesity and an inactive lifestyle could be as much to blame as your favourite steak.This week 17 people - including 2 ambulance crew - were treated for suspected carbon monoxide poisoning at a food plant in Cornwall. The medical adviser to the charity CO Awareness explains how to protect everyone in your home from the accidental poisoning which can have catastrophic effects.NHS screening programmes are based on evidence - so that they target the right groups of people who are most at risk of developing a condition. But more and more private companies are offering tests like CT and ultrasound scans. Abdominal aortic aneurysm is a potentially lethal condition - where the main artery in the abdomen balloons and could burst. Many private companies offer screening for it - but vascular surgeon Hany Hafez from St Richard's hospital in Chichester believes that it's a waste of time and money for women and for men who are under 65 years of age.And Dr Mark Porter gets on a treadmill to answer a listener's question about whether running is truly good for his health - or will end up ruining his knees. Dr Kamran Abassi - the editor of the Journal of the Royal Society of Medicine - casts his expert eye over the evidence behind supplements which are supposed to help keep our joints healthy.

In Inside Health tonight, Dr Mark Porter tackles the confusion and prejudice that surrounds the skin condition Vitiligo - famously said to have been the reason why Michael Jackson skin looked so light. Max Pemberton discovers why surgeons may be wearing masks for their benefit rather than their patients.And Margaret McCartney reminds doctors who tweet to proceed with caution - posting photographs of the first patient you've anaesthetised is likely to get you into trouble!

10 million prescriptions for sleeping pills are written every year in England. So how alarmed should we be over new American research suggesting that people who take them are more likely to die than those who don't? Dr Mark Porter speaks to a leading British sleep expert about the findings and asks what the alternatives are.An Inside Health listener asked us to investigate how safe "electronic" cigarettes are. So Dr Max Pemberton, who uses them himself, talked to Professor John Britton from the UK Centre for Tobacco Control Studies at the University of Nottingham about these currently unregulated products. Rumours abound that a tobacco manufacturer is about to launch the world's first so-called "safe" cigarette. But smokers' reactions are mixed and some prefer other products like nicotine gum.GP Margaret McCartney's column is about whether your doctor's dietary preferences and habits influence your well being.Half of all pregnancies in the UK are unplanned, so women and their babies lose out on important supplements like folic acid to help prevent spina bifida. But for women with an underactive thyroid gland it's even more important that they do their best for their baby by increasing their thyroxine dose as soon as they know they're pregnant. But research from Leicester shows that women often fall through the gaps when seeking care - as GPs, midwives and consultants often think someone else is helping these women.Producer: Paula McGrath.

Dr Mark Porter demystifies the health issues that perplex us and separates the facts from the fiction. He brings clarity to conflicting health advice, explores new medical research and tackles the big health issue of the moment revealing the inner workings of the medical profession and the daily dilemmas doctors face.As new figures published show that 1 in 7 women in England continue to smoke during pregnancy, Inside Health investigates a pilot incentive scheme - which gives women just over £750 worth of vouchers if they give up, and stay off cigarettes for at least 6 months after they give birth. What is the evidence that these incentive schemes work?And what about incentives encouraging doctors to ask whether a patient smokes, or check their blood pressure and cholesterol levels. Dr Margaret McCartney explains why she is one of many GPs who are uncomfortable with the way incentives can influence practicePlus if you've been plagued by a recurring dry tickly cough, it could be caused by a widely used family of blood pressure drug - the ACE inhibitors. Mark Porter investigates.And although it's been slightly warmer that's likely to be cold comfort for 10 million people in the UK with Raynaud's disease where the fingers turn ghostly white after exposure to temperature changes .Presenter: Dr Mark Porter Producer: Erika Wright.

As the Prime Minister announces his efforts to reduce compensation claims for whiplash, Dr Mark Porter asks are doctors having the wool pulled over their eyes? Or are drivers and passengers making mountains out of molehills? Our resident sceptic Kamran Abbasi looks behind recent headlines that suggested weaning your baby on finger foods may be a healthier option than spoon feeding. And in response to our listeners, cholesterol tests - what do they mean, and what should we do about them? Statins are the main mode of prevention for those at greatest risk of heart attack and stroke. But how do you balance the risk of side effects with the protection they provide? We explore the latest research.And how many times have you been to a hospital appointment only to find that the doctor seeing you doesn't have your notes or test results? By 2015, the Department of Health hopes to give us all access to our notes via a centralised electronic record. We examine an alternative approach being tried at various hospitals including Great Ormond Street Hospital. Called Patients Know Best, it works a bit like Facebook and puts the patient in charge.Producer: Beth Eastwood.

Dr Mark Porter demystifies the health issues that perplex us and separates the facts from the fiction. He brings clarity to conflicting health advice, explores new medical research and tackles the big health issue of the moment revealing the inner workings of the medical profession and the daily dilemmas doctors face. This week Mark examines the protocols for visitors to hospitals and asks whether there's any evidence that they help control the spread of infection - is there any science behind using the hand gels provided? Why do some hospitals ban flowers - and should you be able to sit on the hospital bed of your loved one?Martin Kiernan - Nurse Consultant in prevention and control of infection - helps to clear up the confusion. Inside Health discovers that gout - a condition associated with older portly men caricatured in cartoons and literature - is on the increase and striking much younger. And while it has been the butt of many a joke, it has never been a laughing matter - at least for those afflicted.And after the longest grand slam final in history just over a week ago, Mark Porter investigates a new treatment for Tennis Elbow that is used by the top players, Olympic athletes, and is available to mere mortals on the NHS in a handful of places. Plus Dr Max Pemberton investigates whether the explosion in the use of tablets, such as the i-Pad, has caused a similar elbow injury.An Margaret McCartney scrutinises new research suggesting that people with coeliac disease are not the only ones who can develop symptoms if they eat gluten containing foods. Gluten is a component of wheat, barley and rye, and responsible for triggering coeliac disease in around 1% of the UK population, causing problems that include bloating, diarrhoea, weight loss and fatigue. But there now appears to be another group of people with milder symptoms caused by gluten sensitivity - or gluten intolerance - the terms are interchangeable - but how do you identify them? Well certainly not with fancy High Street tests.Producer: Erika Wright.

On Inside Health this week, the bacteria Pseudomonas that's been responsible for a number of deaths in special care baby units in Northern Ireland.Mark Porter asks Prof Richard James, Director of Healthcare Associated Infection at the University of Nottingham, why the outbreak occurred and how the Department of Health is likely to try to prevent future occurrence..We look at a new class of drugs that could transform the lives of tens of thousands of people on warfarin. Recently approved by NICE, the National Institute for Health and Clinical Excellence, these drugs overcome many of the drawbacks of taking warfarin. Mark Porter explores just who is likely to benefit if the drug gets its final endorsement from NICE next week.Mark also explores which prescription drugs are addictive, and how wearing high heels can damage your calves but might improve your sex life.Presenter: Dr Mark Porter Producer: Beth Eastwood.

Inside Health covers the ongoing debate about proposed reforms to the NHS in England. This week Colleges representing nurses, midwives and physios have joined sceptical GPs and hospital specialists by announcing their opposition to the reforms. And, just out, a report by a cross party select committee on health questions whether current financial pressures make it too risky to implement the most radical changes in the Service's history.Health Minister Lord Howe talks to Dr Mark Porter in response to the criticisms from Professor Martin McKee and Dr Clare Gerada in last week's programme..And an Inside Health listener emailed to ask why Tinnitus confuses patients as well as doctors. Dr Max Pemberton investigates.Plus why are teenagers - the most internet savvy generation of all - finding it difficult to access good health information in the internet? Psychologist Ellen Henderson at the University of Bath is one of the authors behind a new study looking at websites aimed at young people and offering advice on treating pain like headaches and period cramps.Vitamin D supplementation is currently recommended for all groups at particular risk of deficiency - such as pregnant and breastfeeding women and young children - but three quarters of parents, and more than half of doctors, midwives and health visitors are not up to speed with the latest guidance, so don't follow it. As Chief Medical Officer for England, Dame Sally Davies, writes to healthcare professionals highlighting the importance of vitamin D supplements Inside Health talks to Nick Bishop Professor of Paediatric bone disease at The University of Sheffield.Finally, our resident sceptic Dr Margaret McCartney explains why she doesn't rate over the counter cough mixtures.Producer: Erika Wright.

The programme that uncovers the real stories behind the health headlines, providing clarity where there's confusion.First, a subject that looks set to be in the headlines this week - growing disquiet about the Health and Social Care Bill and changes to the NHS which include the transfer of responsibility and resources to GPs.Many health experts simply don't understand the reforms, including international public health expert Professor Martin McKee who confesses in this week's British Medical Journal that he doesn't get it either. So what chance is there for the rest of us?It's not just bewilderment that's likely to hinder the implementation of the new Bill. There's active resistance from both hospital consultants and GPs. But what are the reforms going to mean for you? Dr Clare Gerada, the Chair of the Royal College of GPs, discusses this question with Mark.Mark Porter puts his mental agility to the test at the Research Institute for the Care of the Elderly in Bath to find out whether there's any truth behind recent headlines suggesting that our cognitive abilities start to decline from forty five. Professor Roy Jones tells Mark the results of his memory test.And GP Margaret McCartney explores the thinking behind Do No Resuscitate Orders, the record put in a patient's notes when staff feel that attempts to resuscitate them in the event of cardiac arrest are likely to do more harm than good.Finally, the holy grail to combat all flu viruses - a universal vaccine. Mark Porter visits the world's only Flu Camp where new versions of the vaccine are being trialled in volunteers. Professor David Salisbury, Head of Immunisation at the Department of Health, and Dr Kamran Abbasi, Editor of the Journal of the Royal Society of Medicine, join Mark to discuss the use of the current flu vaccine.Producer: Beth Eastwood.

New Series: Dr Mark Porter demystifies the health issues that perplex us and separates the facts from the fiction. He brings clarity to conflicting health advice, explores new medical research and tackles the big health issue of the moment revealing the inner workings of the medical profession and the daily dilemmas doctors face. This week Mark Porter looks at the regulation covering medical devices and implants - everything from artificial joints, to pacemakers and heart valves - and explains why more needs to be done to protect the general public who are often unwitting guinea pigs for untried technology. He asks why is it so much easier to get approval for devices like new hip or breast implants compared with the strict protocols observed for drugs? All you need for most devices is the equivalent of the CE mark - the sort of approval you would expect to find on a toy or a kitchen appliance, not a pacemaker - which may explain why some have unacceptably high failure rates. Inside Health's psychiatrist Dr Max Pemberton investigates a question tweeted to the programme - what's the role of testosterone supplements in men. And following the Prime Minister's comment about Tourette's syndrome Max tells Mark what the condition really involves. Mark talks to Prof Tony Heagerty from the University of Manchester and Professor Tom McDonald from the University of Dundee about new research suggesting that taking pills at night rather than in the morning reduces the risk of complications like stroke and heart attack. And there's a column from GP Margaret McCartney about what goes on in her head when she's making a diagnosis. If there is an issue that confuses you - that you've read or heard about - then please get in touch. Contact us on twitter @BBCRadio 4 using the hash tag #InsideHealth or email the programme via the Radio 4 website. Producer: Erika Wright.