With around six hundred clinics and a reputation unsurpassed anywhere, the Harley Street precinct undoubtedly provides the best medical care in the world. Once the home of famous politicians, scientists, writers, and musicians it now boasts the finest collection of, doctors, hospitals, surgeons and medical organizations. It was originally owned by Edward Harley but is now administered by the Howard de Walden Estate. In order to open up a practice on Harley Street it is necessary to obtain a medical license from the de Walden Estate.

There are many hospitals in the Harley Street area. The Harley Street Clinic draws patients from around the world. It recently opened a cancer center which boasts the latest oncological technology and cancer treatment techniques available. King Edward VII Hospital Saint Agnes was originally established to treat officers wounded in the Boer War. It now provides treatment and care for ex Forces personnel and their families. The Princess Grace Hospital provides high quality care in the specialty areas of spinal surgery, orthopedics, breast assessment and hepatology. Providing the best private maternity care in London is The Portland Hospital for Women and Children. The Heart Hospital is rapidly becoming one of the world’s foremost centers for the prevention and treatment of cardiovascular disorders. The London Clinic is well known for its stem cell transplants and liver transplants.

Cosmetic and plastic surgeons in the vicinity provide aesthetic surgeries in such areas as breast augmentation or reduction, ear pinning, eye bag removal, face lifts, body contouring, Rhinoplasty , and laser skin resurfacing.

Osteopathy is a system of treatment of the body’s musculoskeletal system that promotes strength and movement of muscles, tendons and joints. There are several osteopaths in the Harley Street area.
There are numerous allergy clinics in the Harley Street area. Three of the more well-known are the Association of Clinical Scientists in Immunology, the British Society for Histocompatibility and Immunogenetics and the British Society for Allergy and Clinical Immunology.
The Harley Street area is at the cutting edge in advancing medical technology in many other specialty areas. Some of these are dentistry, orthopedic surgery, urology, dermatology, and endocrinology. Numerous well know chiropractors, gynecologists, psychiatrists, gastroenterologists, neurosurgeons, infertility specialists, and oncologists also practice here.

In addition there are clinics that specialize in such varied areas of medical care as sexual health, addiction, pain management, sports injuries, sleep disorders and women’s health. Hypnotherapy, laser hair removal and physiotherapy services are available as well.

The comprehensive research looked at the cases of over 4,000 overweight and obese people who were treated throughout Sweden over a period of 13 years. Half of this number were those who had elected to have bariatric surgery, either the gastric bypass procedure or the fitting of a gastric band, while the other half had decided against the procedure.

Of the 2,000 who had the weight loss surgery, nearly 200 suffered a heart attack or stroke during the period of the study with 28 of those unfortunately passing away. This compared very favourably to the figures from the group who refused weight loss surgery, 234 of whom suffered a heart attack or stroke in the following years with almost 50 dying as a result.

Although the study doesn’t provide a conclusive link between weight loss surgery and a reduction in the risk of suffering a heart attack, it does suggest that it is never too late to get help to improve your chances of a long and healthy life. Many of those who had the gastric band surgery had been overweight for many years, and had already put their hearts under a lot of strain.

However, by electing to have the weight loss surgery they gave themselves the best possible chances of either avoiding heart problems altogether or surviving them if they did have a heart attack or stroke in later life.

Of course, weight loss procedures, as with any surgery, do come with some risks and those who are at a high risk from heart problems or who have suffered a heart attack previously should be aware that the operation itself will be more dangerous for them. Gastric band procedures are less risky in these situations than gastric bypass and can be just as effective in dealing even with extreme obesity.

• Nose
• Sinuses
• Throat
• mouth
• Pharynx
• Larynx

The lower respiratory tract consists of:

• Trachea
• Bronchi
• Bronchioles
• Alveoli

Respiratory conditions

Respiratory conditions are very common; many conditions are mild but some are very serious and can potentially be life-threatening. Examples of respiratory illnesses include:

• Bronchitis
• Pneumonia
• Common cold
• Sore throat
• Sinusitis
• Tonsillitis
• Laryngitis
• Asthma
• Lung cancer
• Chronic obstructive pulmonary disease (COPD)- this was previously known as chronic bronchitis
• Tuberculosis

Treatment for respiratory conditions

There are many different types of treatment for respiratory conditions; for some illnesses, such as the common cold, there are no treatments to cure the illness because it is caused by a virus, but there are treatments that can ease the symptoms and make patients feel more comfortable.

For people with more serious, chronic illnesses, such as asthma, a long-term treatment may be used; most asthma sufferers have an inhaler with them at all times. Inhalers contain steroids which help to make it easier to breathe.

Treatment for lung cancer may include a combination of therapies; chemotherapy and radiotherapy are most commonly used to treat cancer. Chemotherapy involves taking drugs which destroy cancerous cells, while radiotherapy used specially determined doses of radiation to shrink or destroy tumours.

Treatment for conditions that cause chronic breathing difficulties may involve nebulisation; nebulisers are devices which administer medication by means of an individual inhaling the medication into their lungs. Nebulisers are an example of a medical innovation; nebulisers are commonly used by people with severe asthma and COPD (chronic obstructive pulmonary disease).

In extreme cases, a lung transplant procedure may be carried out; lung transplant procedures involve replacing one or both lungs with the lungs of a donor. Lung transplants are not commonly carried out in the UK; around 120 transplant procedures are carried out in the UK every year. There is a severe shortage of donor lungs and therefore priority is given to people who will benefit from the procedure the most; this means that most donor lungs are given to people under the age of 60.

History of orthopaedics

Historically, orthopaedic medicine was focused on the treatment of crippled children; however the field has expanded greatly over the centuries and orthopaedic specialists now treat patients of all ages and encounter all different kinds of conditions, injuries and diseases.

Modern orthopaedic medicine involves technology and advanced scientific research; there are also elements of engineering in modern orthopaedics, as researchers and doctors look for medical innovations to treat damaged bones and joints and facilitate better movement.

Examples of orthodontic treatment

Orthodontic treatment may involve many different approaches, procedures and therapies; orthopaedic specialists provide both surgical and non-surgical treatment. Examples of surgical treatments include:

• Joint replacement, for example a hip or knee replacement
• Joint fusion (known as androthesis)
• Keyhole surgery (known as arthroscopy)
• Ligament reconstruction and repair
• Re-alignment of a bone (known as osteotomy)

Examples of non-surgical treatments may include:

• Physiotherapy
• Pain relief and medication
• Orthotics (this may include splints, braces and specialist types of footwear)
• Exercises
• Steroid and painkilling injections

Orthopaedic products

There are many different orthopaedic products on the market now; these difference devices and products help to restore the movement and flexibility of joints and support bone growth. Products may range from artificial joints to surgical tools and artificial bone graft substitutes.

The most influential innovations are outlined below:

Cataract surgery

Cataracts are cloudy patches, which develop on the surface of the iris, making it difficult to see; cataracts can develop in one or both eyes and they may cause blurred and double vision. Cataracts cause blurred vision because light is not able to enter the eye through the lens. Cataracts are most common amongst older people but they can affect children very rarely; around 3 in 10,000 children are affected by cataracts.

Cataract surgery has enabled thousands of people to see clearly; the procedure is usually carried out via keyhole surgery. Keyhole surgery is very accurate and eliminates the need for large incisions. The most common type of cataract surgery is called phacoemulsification; during this procedure, a very tiny incision is made in the cornea and the cataract is broken up by a small probe, which generates ultrasound waves. Once the cataract has been broken down, another probe will be inserted to remove the cataract.

Cataract surgery can now be performed in just 45 minutes and the patient can go home shortly afterwards.

Laser eye surgery

Laser eye surgery involves using laser technology to correct problems with the eyes; usually, laser surgery is used to reshape the cornea but there are other types of procedure. The most common types of laser surgery include:

• LASIK (laser in situ keratomileusis): this technique involves cutting the cornea and elevating a flap of tissue; the exposed area is then re-shaped and the flap of tissue is replaced. This technique can be used for most patients with refractive errors.
• PRK (photorefractive keratectomy): this technique involves re-shaping the cornea without having to make an incision and lift a flap of tissue. This method is usually recommended only for people with low prescriptions.
• LASEK (laser epithelial keratomileusis: LASEK is essentially very similar to PRK but the epithelium of the cornea is kept in place; this is thought to facilitate recovery.

Laser surgery is still a relatively new treatment and the long-term effects are largely unknown; however, initial feedback from the treatment has been very positive and many people are delighted with the results of their surgery and can now see perfectly without having to rely on glasses or contact lenses.

Contact lenses

Contact lenses have made a huge difference to many people, as they are much less discreet and often more comfortable than wearing glasses. Many people, especially young people, also worry about their appearance when they wear glasses, so contact lenses have also had an impact on people’s self-esteem and confidence. Contact lenses are small, thin lenses, which are placed over the cornea of the eye; they are adapted to fit the prescription of the individual so that they can see clearly when they out the lenses in their eyes. There are now many different types of contact lens, including disposable contact lenses and monthly lenses.

Heart surgery

Heart disease is very common, especially amongst people over the age of 50; as a result of this, many people require procedures and operations to help restore the function of their heart and clear their blood vessels, so that blood can be pumped around the body easily. More than 30,000 people in the UK have heart surgery every year.

Types of procedure

There are different types of heart surgery, which aim to correct different problems, these include:

Coronary angioplasty: a coronary angioplasty is a procedure, which is used to facilitate blood flow around the body, by widening or unblocking the coronary arteries. During the procedure, a catheter is used to insert a stent into the artery; a stent is a small, hollow metal tube. A balloon is used to open the stent and this pressure causes the stent to widen; this enables blood to flow more freely around the body. A coronary angioplasty may be carried out for people with chronic angina (chest pain) or as an emergency measure after somebody has had a heart attack.

Coronary heart bypass: coronary heart bypass surgery is used to treat people with coronary heart disease; the procedure involves diverting the blood around areas that are narrow or blocked, so that blood can flow around the body more easily. The procedure involves taking a blood vessel from a different part of the body and attaching it to the coronary artery in areas where the artery is narrow or blocked. In most cases, the surgeon will take a number of grafts so that the operation does not have to be repeated in the future.

Heart transplant surgery: heart transplant surgery is a medical innovation; it involves taking the heart from one person and putting it in another person. Heart transplant surgery is a very complex procedure, which is usually only carried out when a person has severe heart disease and will die if they do not get a new heart. Donor hearts are taken from people who have died and agreed to donate their organs. As technology has advanced, other treatments have become available and these can be used to keep the heart going until a donor heart becomes available; one of these treatments, a left ventricular assist device, can be used to support the heart until a suitable donor can be found.

What is cancer?

Cancer is a disease, which is characterised by abnormal reproduction of the cells; cancerous cells can invade healthy tissue and this can affect bodily function. Cancer can spread from the original site to other parts of the body; this process is called metastasis.

What are the causes and symptoms of cancer?

There is no single cause of cancer but several risk factors have been identified; these include:

• Smoking
• Excessive drinking
• Poor diet
• Family history
• Exposure to environmental factors

Sometimes, there appears to be no cause of cancer; healthy, fit individuals can develop cancer.

In some cases, there are no symptoms of cancer; some forms of cancer, such as ovarian cancer, are known as silent killers, as there are often no symptoms or very general symptoms, which may be associated with other common illnesses or conditions. Many forms of cancer do present symptoms and common symptoms include:

• Abnormal lumps and swellings
• Changes in appetite and sudden weight loss
• Changes in bowel habits
• Persistent coughing and breathing difficulties
• Blood in the urine or faeces
• Changes in the feel or appearance of moles

Treatment

There is still no cure for cancer but treatments have become much more effective in recent years. Research has helped to develop new treatments and methods and chemotherapy and radiotherapy are examples of modern medical innovations. Chemotherapy is a combination of medications, which are designed to destroy cancerous cells, while radiotherapy is a treatment which uses radiation to shrink tumours and kill cancerous cells. Sometimes, a combination of therapies is used to treat cancer and surgery may also be carried out. As technology has become more advanced, treatments have become more effective and developments in the diagnostic process have also enabled doctors to treat patients quicker and this has improved survival rates.

Cancer research

Cancer research plays a vital role in the fight against cancer; a huge amount of time and money is invested in cancer research every year, with the aim of finding a cure for cancer. Research projects are carried out in countries across the world and aim to find effective treatments, explore the causes and risk factors associated with cancer and try to find ways of preventing cancer. Cancer research has become more effective in tandem with advances in technology and science and research can now use different techniques and equipment to explore different aspects of cancer and try to identify possible ways of improving survival rates.

One of the most common ways to quit is through counselling sessions. Counselling can come in a number of ways, including group counselling where the combined efforts of the group can help each individual to stop, or one to one counselling involving just the smoker and a counsellor. As with other methods mentioned earlier, the effectiveness of these methods can vary from person to person.

Group Counselling

A number of companies run group counselling sessions within the UK with their own trained counsellors, these group counselling sessions are usually held in the workplace by companies to help their employers stop smoking.

One such company is quit.org.uk who runs a number of different programmes to help people quit smoking. Their group counselling sessions usually last 6 weeks at one hour per session and it has been found that those attending group support are more likely to quit than giving up unaided.

One to One Counselling

One to one counselling has also been found to be highly effective and again is run by a number of companies and groups within the UK, including the NHS.

One to one counselling sessions have been found to be increasingly effective and successful. Surprisingly bi-weekly counselling sessions of 30 minutes, were found to be much more effective than weekly counselling sessions of a shorter period.

Statistically with one to one counselling an impressive 25.5% of attendees who attended over 300 minutes of counselling successfully quit smoking and continued to stay smoke free after the sessions ended.

Unaided Quitting

Methods, such as nicotine and counselling, are relatively new and were not largely seen until the 1980s. Before that many people were still able to quit smoking by simply going “cold turkey” and gradual decreased the frequency of their smoking.

Even now, in today’s society, when help with smoking is so common, an exceptionally high number of quitters have credited nothing more than their own will power to giving up smoking. The percentage of people able to give up purely unaided is debated, but has been claimed to be as high as 76% in the US by some experts.

Public health initiatives can sometimes be seen as a little dictatorial but the small change, big difference initiative is a simple and effective way to improve your health without really feeling like you are making an effort. An extra piece of fruit a day will help improve your health without breaking the bank and maybe if you work in London getting off the lift a couple of floors before yours and walking up the rest could help too. Walking up escalators on the tube or walking to the train station instead of driving could also have an added effect over a period of time.

When it comes to public health initiatives there is only so much that can be done by health or government officials can do. Information and advice can be made public knowledge for ideas and suggestions on how to improve your health but it is still up to the individual to actually use them in their daily lives.

Public health initiatives have a bad reputation with many failing to improve the health of those they try and target. It is seen that these 1700 people would be far better employed working directly on public health rather than advising the government what public health initiatives should be created. After failed drinking, smoking and STI initiatives you can understand why the government has realised it is a waste of money to employ them as consultants.

We have heard for years that there are too many administrative workers in the health service. The moving of 1700 health professionals to consultants working on failing public health initiatives is the perfect example of this. To ensure that we can improve the health service what we need is more health professionals treating people and far fewer coming up with the ideas. After all why does it take 1700 people to come up with public health initiatives?