Showing posts with label Health News Blog. Show all posts
Showing posts with label Health News Blog. Show all posts

Friday

Transgender Teen Care 'Needs Urgent Regulation'

Transgender Teen Care 'Needs Urgent Regulation'

Young transgender people are being let down by the "terrible" quality of evidence underpinning their treatment and care, a leading researcher warns.

Prof Carl Heneghan, from Oxford University, said there was an "urgent" need for a new regulator in the field.

He said much more "rigorous" and "robust" research was needed into the effects of drugs given to young transgender people.

But the Department of Health says it has no plans to create a new regulator.

Prof Heneghan, director of the Centre of Evidence Based Medicine at Oxford University, along with Prof Tom Jefferson, who is also a clinical epidemiologist carried out an independent analysis of the most recent international research on medical interventions for the BBC's Panorama programme.

Prof Heneghan said "One of the key issues is to be able to say to parents and children in making a decision... 'Here's an informed decision based on the evidence.'

"The quality of evidence in this area is terrible."

One of the key elements of treatment is puberty blockers, which may be prescribed to young people with gender dysphoria.

They prevent the development of characteristics such as breasts or facial hair.

Puberty blockers have long been used to treat young children who start puberty too early but less is known about their long-term safety in transgender adolescents.

'Huge distress'

Prof Heneghan said: "What can you tell from the evidence? You can tell very little apart from they give you the intended effects of suppressing and blocking puberty."

Dr Polly Carmichael, a consultant clinical psychologist and director of the NHS Gender Identity Development Service, at the Tavistock Centre, said: "There are questions around risk.

"What you have is a phenomenon and that phenomenon is young people who are hugely distressed around their gender identity.

"I think that it is important that young people and families who have gone forward for treatment are exceedingly positive about it."

'It helps to take time'

Now 18, Jade, was referred to child mental health services for depression in her early teens. Realising that she was conflicted about her gender identity, they referred her on to the Tavistock Centre.

She spent a year on the waiting list, before starting counselling when she was 16-years-old.

"I took a lot of time playing with my identity, which I think is an important thing to do, especially for young people, because it gave me that time to realise that I lived my life as a feminine guy but that wasn't it. There was something more to it," she says.

"When people see me on the street, I want to be perceived as a woman."

Jade, like most under-18s referred to the Tavistock, didn't take puberty blockers or cross-sex hormones while she was a patient there.

"There's just so much thinking that needs to be done, especially to making life changes to go down the line like hormone blockers, when there are so many changes happening in your body," she says.

"It just helps to take time."

Jade says she's still struggling with gender dysphoria but is now ready for the next stage in her transition.

When children have been on puberty blockers for a year, and are about 16, they can be offered cross-sex hormones by the NHS - testosterone and oestrogen, the effects of which can be irreversible.

'Emotive' Area

Prof Heneghan said the way the research studies had collected and analysed evidence "prevented definitive conclusions" to be made on young people's outcomes with cross-sex hormones.

He said the number of patients in the research groups was small and many patients were "lost" from the studies, so their outcomes were not followed up.

The Tavistock Centre has undertaken its own research into patients but he said they had not done enough.

"They haven't produced systematic data on the outcomes based on all children," Prof Heneghan said.

"In the absence of evidence, I just do not understand how they can inform children, adolescents and parents and families in a way that helps them make an informed decision."

However, Dr Carmichael said the centre had recently been given a research grant "to follow young people who come to the service through and forward, whatever their outcomes, and that is going to be really important information".

The Tavistock Centre also said it engaged in research and published regularly.

But Prof Heneghan said a new regulator was urgently needed to provide oversight of the care and treatment offered by both the NHS and private providers.

He likened the "emotive" area of care for transgender children to that for fertility and called for a new regulator to oversee research and treatment, similar to the Human Fertilisation and Embryology Authority (HFEA), which would be independent to those providing the care.

The Department of Health said it had no plans to introduce an independent regulator but added: "We are committed to ensuring thorough accountability and oversight... and will review any arrangements when appropriate."

Panorama: Trans Kids - Why Medicine Matters is available on BBC iPlayer. Dr Faye Kirkland is also a GP.

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Type-2 Diabetes: 'Weight Loss Arrests Disease for Years'

Type-2 Diabetes: 'Weight Loss Arrests Disease for Years'

Consuming 850 calories a day for three months and then keeping the weight off can arrest type-2 diabetes for at least two years, a study suggests.

The GP-led programme worked for more than a third of participating patients.

The study report builds on earlier work suggesting weight loss is one key solution and offers more time off medication than previously thought.

Experts say it challenges the view that type-2 diabetes is always a life-long, progressive condition.

Type-2 diabetes affects one in 16 adults in the UK.

It causes uncontrolled sugar levels that can lead to serious complications such as amputations, visual problems and heart disease.

'I Lost 17kg in 12 Weeks'

Joe McSorley, 58, who lives near Glasgow, was diagnosed with type-2 diabetes six years ago and though he was given two types of medication, found it hard to keep his blood sugars under control.

He told BBC news: "All I could see for the future was continuing to take these pills forever."

When he started the trial diet - consuming only low-calorie shakes every day - he found it very difficult.

But he saw rapid results, dropping from 90kg (14st 2lb) to 73 kg in just 12 weeks.

And, Mr McSorley said, the hardest part came when he had begun to eat solid food again.

"Using the shakes is only the start of the journey," he said.

"It gets you to the point where you can take destiny in your own hands."

Two years later, his weight is stable at 77kg.

He exercises regularly and hopes to become a lifestyle coach when he retires.

Mr McSorley was one of 149 people in Scotland and Tyneside put on a 12-30-week low-calorie diet of shakes and drinks to help trigger weight loss.

They were then reintroduced to solid meals over the next few weeks.

After one year, 69 of them (46%) had gone into remission, compared with just 4% of people given standard treatment including pills.

And after two years, 53 of them (36%) remained off medication and in remission.

Participants were encouraged to keep healthy through monthly meetings and had the option of a "rescue" plan including using the liquid diet again, if they gained weight.

'Not All About Weight'

Prof Roy Taylor, an investigator on the trial at Newcastle University, said: "These results are a significant development and finally pull down the curtain on the era of type-2 diabetes as an inevitably progressive disease."

Researchers said most of the weight-loss group whose diabetes had gone into remission had lost 10kg or more and maintained this weight loss during the trial.

But Dr Nicola Guess, at King's College London, said weight loss was not the whole story.

"Type-2 diabetes returned in a minority of people (16%) who kept off 15kg or more for two years," she said.

"Further research is needed to help us understand why this is.

"It is possible that these people had type-2 diabetes for longer before losing weight or perhaps there might be dietary or genetic factors which contributed."

The NHS in England is planning on piloting the programme and NHS Scotland has begun rolling out similar schemes. But NHS experts caution that this type of calorie restriction is not be suitable for everyone and should be done under medical supervision only.

The charity Diabetes UK, which funded the study, said the findings were exciting but added: "We know type-2 diabetes is a complex condition and this approach will not work for everyone."

The trial is published in the Lancet Diabetes and Endocrinology.

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Monday

Canada Appeals Court Orders Tobacco Firms to Pay Billions in Damages

Canada Appeals Court Orders Tobacco Firms to Pay Billions in Damages

A Canadian court has upheld the bulk of a decision that ordered three tobacco companies to pay billions in damages.

The judgment involves class action suits that were consolidated against Imperial Tobacco Canada, Rothmans Benson & Hedges and JTI-MacDonald.

The companies had appealed a 2015 ruling in favour that ordered them to pay over C$15bn (£8.5bn; $11bn).

The plaintiffs were Quebec smokers who said the firms failed to warn them of health risks associated with smoking.

Rothmans, Benson & Hedges said on Friday it will seek leave to appeal to the Supreme Court of Canada.

JTI-Macdonald Corp said it "fundamentally disagrees" with the decision and is considering all options, including an appeal.

Plaintiffs said the firms knew since the 1950s that their product was causing cancer and other illnesses and failed to warn consumers.

The companies had argued that Canadians have had a "high awareness" of smoking health risks for over half a century and say they have been strictly regulated.

The Quebec Court of Appeal sided on Friday with a lower court decision that concluded the companies had failed to provide adequate information about the "safety defect" in their tobacco products.

This is the largest award for damages in the country's history and will include interest on those damages.

The two class-action lawsuits were originally filed in 1998 before they were consolidated.

Smoking rates have reduced steadily in Canada over the years and in 2017 just under 17% of Canadians smoked at least occasionally.

In recent years, US courts have ordered tobacco companies to pay large awards.

But those payouts are often reduced upon appeal.

A $28 bn (£18.3 bn) ruling against Philip Morris was reduced to $28m on appeal in 2011.

American tobacco firms agreed in 1998 to pay US states over $200 bn (£131 bn) in fines in what is the largest civil litigation suit in US history. US states have been criticised for not spending enough of the compensation on anti-smoking programmes.

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Quick Pregnancy is Safe After Stillbirth, Study Finds

Quick Pregnancy is Safe After Stillbirth, Study Finds

There is no reason to delay having another baby after a stillbirth, research in the Lancet suggests.

Although women are often told to wait for a year before getting pregnant again, there is little evidence to back up this advice.

This international study of 14,000 births found no increased risk of problems if conception happened earlier.

A UK stillbirth expert said the findings were important and reassuring.

About one in every 225 births in the UK ends in stillbirth, which is defined as the death of a baby after 24 weeks of pregnancy in the UK. However, in this study, a stillbirth is defined as a baby's death after 22 weeks' pregnancy.

Stillbirth rates have been gradually reducing in the UK since 2000, and more sharply since 2015, but compared with many other European countries, improvements in the UK have been slow.

In many countries there is limited guidance available on planning future pregnancies after stillbirth, the study says.

Manchester University's Prof Alex Heazell, spokesman for Tommy's stillbirth charity and the Royal College of Obstetrics and Gynaecology, said his message to women was "not to worry".

"As long as they get all the information about why their baby died, then the choice of when to have another baby is down to when they are psychologically ready."

He said there was no physiological reason to wait more than a year before trying for another baby.

"Stress may exacerbate things and so waiting until that goes may be a reason for some to hold off," Prof Heazell said.

To Wait or Not

The researchers looked at the birth records of 14,452 women who had previously had a stillbirth in Western Australia, Finland and Norway over 37 years.

A total of 2% of those subsequent pregnancies ended in stillbirth, 18% were preterm births and 9% were babies born small for their age.

The study found that those who conceived within 12 months of stillbirth were no more likely to have another stillbirth, or a preterm birth, than women who left two or more years between pregnancies.

Out of the births studied, 9,109 or 63% were conceived within 12 months of the stillbirth.

The study, led by Dr Annette Regan, from Curtin University in Australia, said the findings were useful for clinicians who give counselling after stillbirths.

She said women who did not leave enough time to recover after a previous pregnancy could be at risk of "poor nutritional status, which has been linked to increased risk of foetal growth restriction and birth defects".

But she said this may be less likely to occur after a pregnancy loss, such as stillbirth or miscarriage.

Commenting on the research, Mark A Klebanoff, from the Research Institute at Nationwide Children's Hospital in the US, said there were other factors to consider.

"Rather than adhering to hard and fast rules, clinical recommendations should consider a woman's current health status, her current age in conjunction with her desires regarding child spacing and ultimate family size, and particularly following a loss, her emotional readiness to become pregnant again."

What is stillbirth?

A stillbirth is when a baby is born dead after 24 completed weeks of pregnancy
If the baby dies before 24 completed weeks, it is known as a miscarriage or late foetal loss.

Some stillbirths are linked to complications with the placenta, a birth defect or with the mother's health. For others, no cause is found.

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Saturday

Experimental Treatment Offers Hope to Restore Cells Damaged in Parkinson's Disease

Experimental Treatment Offers Hope to Restore Cells Damaged in Parkinson's Disease

A pioneering clinical trials program that delivered an experimental treatment directly to the brain offers hope that it may be possible to restore the cells damaged in Parkinson's disease. The study investigated whether boosting the levels of a naturally-occurring growth factor, Glial Cell Line Derived Neurotrophic Factor (GDNF), can regenerate dying dopamine brain cells in patients with Parkinson's and reverse their condition, something no existing treatment can do. Potentially promising results of the third arm of the trials, an open-label extension study, are reported in the Journal of Parkinson's Disease.

The three-part multimillion-pound GDNF study was funded by Parkinson's UK with support from The Cure Parkinson's Trust and in association with the North Bristol NHS Trust.

Six patients took part in the initial pilot study to assess the safety of the treatment approach. A further 35 individuals then participated in the nine-month double blind trial, in which half were randomly assigned to receive monthly infusions of GDNF and the other half placebo infusions. After the initial nine months on GDNF or placebo, the open-label extension study took place, which explored the effects and safety of continued exposure to GDNF for another 40 weeks in the patients previously receiving GDNF (80 weeks in total) and the effects of 40 weeks of open label GDNF in those subjects who had previously received placebo for the first 40 weeks. All 41 patients randomized and treated in the parent study (prior GDNF and placebo patients) were enrolled and completed the open label extension study.

A specially designed delivery system was implanted using robot-assisted neurosurgery. This delivery system allowed high flow rate infusions to be administered every four weeks and enabled so called Convection Enhanced Delivery (CED) of the study drug. Four tubes were carefully placed into each patient's brain, which allowed GDNF to be infused directly to the affected areas with pinpoint accuracy via a skull-mounted transcutaneous port behind the ear. After implantation and over the following several years the trial team administered, more than 1000 brain infusions, once every four weeks over 18 months to study participants. The high compliance rate (99.1%) in participants recruited from throughout the UK has potentially demonstrated that this new administration process for repeated brain infusion is clinically feasible and tolerable.

After nine months, there was no change in the PET scans of those who received placebo, whereas the group who received GDNF showed an improvement of 100% in a key area of the brain affected in the condition, offering hope that the treatment was starting to reawaken and restore damaged brain cells.

"The spatial and relative magnitude of the improvement in the brain scans is beyond anything seen previously in trials of surgically delivered growth-factor treatments for Parkinson's," explained principal investigator Alan L. Whone, PhD, FRCP, Translational Health Sciences, Bristol Medical School, University of Bristol, and Neurological and Musculoskeletal Sciences Division, North Bristol NHS Trust, Bristol, UK. "This represents some of the most compelling evidence yet that we may have a means to possibly reawaken and restore the dopamine brain cells that are gradually destroyed in Parkinson's."

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By 18 months, when all participants had received GDNF, both groups showed moderate to large improvements in symptoms compared to before they started the study and that GDNF was safe when administered over this length of time. However, no significant differences between the groups (placebo followed by GDNF versus GDNF for the entire study period) in the primary and secondary clinical endpoints were seen.

The question of whether clinical benefits lag behind biological changes seen in PET scans during disease reversal or need a longer period of repeated exposure to the drug to develop cannot be answered definitively on the basis of the extension study results. However, the integrated results of the two studies suggest that:
* Attending on an out-patient basis over 18 months, to receive infusions every four weeks via a skull-mounted port, is feasible.

* This treatment regimen and novel method of drug administration are well tolerated.
* Further testing of GDNF in a larger-scale study and including the use of higher doses are required to definitively determine whether GDNF has a future role as a neurorestorative treatment for Parkinson's.

According to Steven Gill, MB, MS(Lond.), FRCS, lead neurosurgeon and designer of the CED device, of the Neurological and Musculoskeletal Sciences Division, North Bristol NHS Trust, Bristol, and Renishaw plc, New Mills, Wotton-under-Edge, Gloucestershire, UK, "This trial has shown that we can safely and repeatedly infuse drugs directly into patients' brains over months or years. This is a significant breakthrough in our ability to treat neurological conditions, such as Parkinson's, because most drugs that might work cannot cross from the blood stream into the brain due to a natural protective barrier."

"It's essential to continue research exploring this treatment further - GDNF continues to hold potential to improve the lives of people with Parkinson's," commented Dr. Whone.

I believe that this approach could be the first neuro-restorative treatment for people living with Parkinson's, which is, of course, an extremely exciting prospect," added Dr. Gill.

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Almost Half of All Childhood Cancer Cases Go Undiagnosed

Almost Half of All Childhood Cancer Cases Go Undiagnosed

A new study published in The Lancet Oncology estimates that almost half of all children in the world who have cancer are not diagnosed or treated, leaving them to "die at home."

The study found that around 400,000 new cases of childhood cancer arise every year, but only 200,000 of these are diagnosed and therefore recorded.

The study authors say this can occur due to a lack of access to primary care, with children ending up dying undiagnosed at home.

The new "Global Childhood Cancer" model showed that under-diagnosis of childhood cancer is a particular problem in South Asia and Western Africa, where rates were high as 49% and 57%, respectively.

In North America and Europe, only 3% of childhood cancers were left undiagnosed. Study author Zachary Ward (Harvard TH Chan School of Public Health) and colleagues estimate that 3 million cases will be undiagnosed by 2030 if improvements are not made.

Previous estimates have been based on records from cancer registries, but 60% of countries do not have these registries, meaning the estimates only cover a small proportion of the global population.

The new model incorporates cancer registry data but also includes information from the World Health Organisation's Global Health Observatory, demographic health surveys and household surveys developed by UNICEF.

Accurate estimates of childhood cancer incidence are critical for policymakers to help them set healthcare priorities and to plan for effective diagnosis and treatment of all children with cancer. While under-diagnosis has been acknowledged as a problem, this model provides specific estimates that have been lacking."

Zachary Ward, First Author

The most common childhood cancer in 2015 was found to be acute lymphoblastic leukaemia, with 75,000 new cases identified worldwide, including almost 700 in Northern Europe, more than 1,500 in West Africa, over 3,500 in East Africa and almost 30,000 in South Central Asia.

Ward says the positive news is that many countries are committing to universal health coverage, which will help improve children's access to healthcare, although investment in cancer registries is still needed so that progress can be monitored.

Only real-world data can give us the true picture in a given country or region of the world. Cancer registries must be given the legislative, political and financial stability to collect complete and high-quality data in a timely fashion." - Dr. Claudia Allemani, Cancer Epidemiologist at LSHTM.

Ward, Z. J. et al. 2019. Estimating the total incidence of global childhood cancer: a simulation-based analysis. The Lancet Oncology.

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Wednesday

Morning Walks Could Be Better Than Drugs At Lowering Blood Pressure

Morning Walks Could Be Better Than Drugs At Lowering Blood Pressure

According to a new study published in the journal Hypertension, just half-an-hour of walking in the morning could be as effective as medication at lowering blood pressure.

Researchers at the University of Western Australia found that 30 minutes of walking on a treadmill in the morning improved participants' blood pressure readings for the rest of the day. They say that for some individuals, the morning walking could replace the need for medication.

According to the charity Blood Pressure UK, about one-third of adults have high blood pressure, which is defined as a reading of more than 140/90 mmHg and, in Britain, about 12 million people take medication for the condition.

For the study, Michael Wheeler and colleagues assessed 67 overweight and obese men and women (aged 55 to 80) who engaged in three different 8-hour daily routines.

The first routine involved sitting continuously for eight hours. The second involved sitting for one hour before walking for 30 minutes at moderate intensity on a treadmill, followed by sitting for a further 6.5 hours.

The third routine involved sitting for one hour before 30-minute treadmill walking and then sitting for 6.5 hours, but with this interrupted every 30 minutes with 3 minutes of light intensity walking.

The results showed that blood pressure was significantly lower when participants engaged in the routines that involved walking, compared with the sitting-only routine.

Wheeler says that the magnitude of the blood pressure reduction approached that of what may be expected when this population group take anti-hypertensive medication.

Commenting on the study, the British Heart Foundation added that half-an-hour of morning exercise is also good for people's mental health.

Cardiac nurse at the British Heart Foundation, Chris Allen, says the findings add to a huge body of evidence showing that regular exercise can help to lower blood pressure and reduce the risk of heart attacks and strokes: "It can also give both your body and mind a boost, which is why 30 minutes of activity in the morning is a great way to set yourself up for the day."

As the proportion of those who are overweight with higher blood pressure increases with age, adopting a strategy of combining exercise with breaks in sitting may be important to control and prevent the development of high blood pressure." - Professor Michael Wheeler, Lead Author.

Wheeler, M., J., et al. 2019 Effect of Morning Exercise With or Without Breaks in Prolonged Sitting on Blood Pressure in Older Overweight/Obese Adults. Hypertension.

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Radical Parkinson's Treatment Tested in Patients

Radical Parkinson's Treatment Tested in Patients

A radical Parkinson's treatment that delivers a drug directly to the brain has been tested in people.

Patients in the trial were either given the drug, which is administered via a "port" in the side of the head, or a dummy treatment (placebo).

Both groups showed improved symptoms, meaning it was not clear if the drug was responsible for the benefits.

However, scans did find visual evidence of improvements to affected areas of the brain in those given the drug.

The study's authors say it hints at the possibility of "reawakening" brain cells damaged by the condition.

Other experts, though, say it is too early to know whether this finding might result in improvements in Parkinson's symptoms.

Researchers believe the port implant could also be used to administer chemotherapy to those with brain tumours or to test new drugs for Alzheimer's and stroke patients.

Parkinson's causes parts of the brain to become progressively damaged, resulting in a range of symptoms, such as involuntary shaking and stiff, inflexible muscles.

About 145,000 people a year in the UK are diagnosed with the degenerative condition, which cannot be slowed down or reversed.

For this new study, scientists gave patients an experimental treatment called glial cell line-derived neurotrophic factor (GDNF), in the hope it could regenerate dying brain cells and even reverse the condition.

Participants underwent robot-assisted surgery to have four tubes placed into their brains, which allowed GDNF to be infused directly to the affected areas with pinpoint accuracy, via a port in their head.

After an initial safety study of six people, 35 patients took part in a nine-month "blinded" trial, where half were randomly assigned to receive monthly infusions of GDNF and the other half dummy infusions.

Dr Alan Whone, principal investigator, said patients in the trial had, on average, been diagnosed eight years previously, but brain scans of those given the drug showed images that would be expected just two years after diagnosis.

He said: "We've shown with the Pet [positron emission tomography] scans that, having arrived, the drug then engages with its target, dopamine nerve endings, and appears to help damaged cells regenerate or have a biological response."

'I Feel it Brought Me Time'

Tom Phipps, 63, from Bristol, said he had noticed an improvement during the trial and had been able to reduce the drugs he takes for his condition.

Since it ended, he has slowly increased his medication but is continuing to ride his bike, dig his allotment and chair his local branch of Parkinson's UK.

"My outcome was as positive as I could have wished for," he said.

"I feel the trial brought me some time and has delayed the progress of my condition.

"The best part was absolutely being part of a group of people who've got a similar goal - not only the team of consultants and nurses but also the participants.

"You can't have expectations - you can only have hope.

Following the initial nine months on GDNF or placebo, all participants had the opportunity to receive GDNF for a further nine months.

By 18 months, when all participants had received GDNF, both groups showed moderate to large improvements in symptoms compared with their scores before they started the study.

But the authors say the results need to be treated with caution because of the possibility of the placebo effect - when a patient feels better despite taking a medicine with no active ingredient.

Researchers hope that further trials could look at increasing the doses of GDNF or the duration of treatment.

'A New Horizon'

Dr Arthur Roach, director of research at Parkinson's UK, which funded the study, said: "While the results are not clear-cut, the study has still been a resounding success.

"It has advanced our understanding of the potential effects of GDNF on damaged brain cells, shown that delivering a therapy in this way is feasible and that it is possible to deliver drugs with precision to the brain."

Prof K Ray Chaudhuri, from the Institute of Psychiatry, Psychology and Neuroscience, King's College London, who was not involved in the study, said it was "disappointing" that the difference in symptoms was not significant.

But he said the study was still of "great interest and should point towards a new horizon and direction to restoration-based treatments".

The findings from the trials are published in the medical journals Brain and the Journal of Parkinson's Disease.

The study also features in a two-part BBC Two documentary series, The Parkinson's Drug Trial: A Miracle Cure? on 28 February and 7 March, at 21:00.

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'Know Your Cholesterol Like You Know Your Pin Code'

'Know Your Cholesterol Like You Know Your Pin Code'

People are being encouraged to know their cholesterol and blood pressure numbers as well as they know their bank Pin code - because it could save their life.

These numbers flag up early signs of cardiovascular disease, which can lead to heart attacks and strokes.

Forty health organisations have teamed up to urge more people to go for a routine NHS health check.

Doctors should also identify and treat at-risk patients better, they say.

Cardiovascular disease (CVD) causes one in four deaths in England, the equivalent of someone dying every four minutes, according to Public Health England and NHS England.

Poor heart and artery health can also lead to heart failure, kidney disease, arterial disease and vascular dementia.

So, health bodies are leading efforts to improve the detection and treatment of three conditions that contribute to CVD - atrial fibrillation, high blood pressure and high cholesterol - over the next 10 years.

These conditions often have no symptoms, which is why health experts are recommending people aged over 40 take up a free NHS health check.

These can be booked at GP surgeries. They are also available at some local pharmacies and shopping centres.

PHE recommends checking your local area to find out where they are being offered.

People over 30 are being urged to take the Heart Age Test.

'I Had to Give Up Work'

Keith Wilson, from Liverpool, had a heart attack out of the blue at 37.

"I had no symptoms and no reason to believe I was sick in any way," he says.

His father had died of heart disease in his late 60s so he assumed it was something that happened to older people.

"I just didn't consider I was going to get it. I was complacent," he says.

After a second heart attack, Keith spent the next three to four years in and out of hospital receiving treatment.

He had to give up work and this really affected his family and young son.

Now 60, Keith is mindful of his health and keeps a close eye on how much he drinks and exercises. He gave up smoking straight after his heart attacks.

What is high cholesterol?

Cholesterol is carried in your blood by proteins. It can build up in the artery walls, restricting blood flow to the heart, brain and rest of the body. It can be measured with a blood test.

Total cholesterol levels should be:

  • 5mmol/L or less for healthy adults
  • 4mmol/L or less for those at high risk
  • You are at high risk if you have a family history of heart disease, heart attacks or strokes, are overweight or have high blood pressure.
What is high blood pressure?

Blood pressure is recorded using two numbers - the systolic pressure at which the heart pumps blood around your body and the diastolic pressure which measures resistance to blood flow in the blood vessels.
  • high blood pressure is usually 140/90mmHg or higher
  • ideal blood pressure is usually between 90/60mmHg and 120/80mmHg
  • low blood pressure is lower than 90/60mmHg
Most cases of CVD are preventable and, alongside free health checks, PHE recommends people should:
  • stop smoking
  • eat healthily
  • keep to a healthy weight
  • drink at safe levels
The report also calls on health professionals to improve the way they manage patients at risk of CVD.

By 2029, PHE and NHS England want:
  • 80% of people with high blood pressure detected and treated - up from 57% currently
  • 75% of 40- to 74-year-olds having cholesterol levels measured - fewer than 50% currently take up the free health check
  • 45% of 40- to 74-year-olds at high risk of CVD treated with statins - up from from 35% currently
  • These targets will help meet the commitment to prevent 150,000 heart attacks, strokes and cases of dementia, as set out in the government's long-term plan for the NHS.
But there is no new funding for these new targets.

'Needlessly at risk'

Duncan Selbie, chief executive of Public Health England, said: "We know our Pin numbers but not the numbers that save our lives.

"Thousands of heart attacks and strokes can be prevented by more people knowing their blood pressure and cholesterol numbers and by seeking help early."

Prof Stephen Powis, NHS medical director, said reducing health inequalities was also a priority, with people in the most deprived communities four times more likely to die prematurely from CVD than those in the most well off.

England's Health Secretary Matt Hancock said: "Almost half of those with high blood pressure are going about their daily lives without it being detected or treated.

"Millions of people are needlessly at risk of heart attacks or strokes when it could be prevented.

"So, I want to help more people take the time out to protect their future health and get checked."

Five million people are estimated to have undiagnosed high blood pressure in England.

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Sunday

What Diet is Best for Older Adults?

What Diet is Best for Older Adults?

A new study has revealed that a diet rich in protein and low in calories can help older adults with obesity lose more weight while maintaining muscle mass and improving bone density.

Losing weight as an older adult presents some challenges.

Older adults often lose bone density and muscle mass when they concentrate on shedding weight.

This unwanted bone and muscle loss can result in mobility issues and can even increase a person's risk of injury.

A recent study, which Wake Forest University in Winston-Salem, NC, is the lead on, has shown that a high-protein, low-calorie diet can help adults avoid these problems.

Several peer-reviewed journals, which include Journals of Gerontology: Medical Sciences and American Journal of Clinical Nutrition have accepted four research papers from the study for publication.

The researchers randomly selected 96 adults over 65 years of age and assigned them to one of two groups.

They put the first group on a 6-month, low-calorie meal plan that was also high in protein - more than 1 gram (g) of protein per kilogram (kg) of body weight. They assigned the other group to a weight-maintenance plan that included 0.8 g of protein per kg of body weight.

High-protein, Low-calorie

Those in the high-protein, low-calorie diet group experienced the most weight loss, but more revealing was that those in this group maintained their muscle mass. They also lost weight on the stomach, hips, thighs, and rear, which can decrease the risk of certain medical conditions, including diabetes and stroke.

Furthermore, the researchers found that the participants in the high-protein group improved their bone quality, and they gained 0.75 points on their Health Aging Index scores, involving longevity and mortality biomarkers.

Kristen Beavers, assistant professor of health and exercise science at Wake Forest and lead investigator of this study, led earlier, smaller studies where she scrutinized the planning and preparation of the participants' meals. For this study, though, with its greater number of participants, she wanted to find a more cost-effective method.

Consequently, the study asked those in the weight-loss group to use four meal replacements every day and to prepare two meals of lean protein and vegetables each day. The team allowed each participant one healthy snack per day to wrap up a low-calorie, high-protein meal plan. Those in the other group were instructed to maintain their regular diet and usual activities.

Older Adults and Nutrition

Older adults have unique nutritional needs and may need to make changes to their diets as the years go by. Muscle mass can decrease as a natural part of aging, and people do not burn calories at the same rate as they do during their younger years.

Targeting nutrient-dense foods is essential for older adults, and avoidance of high-calorie foods that lack vital nutrients is crucial.

Beneficial foods include fruits, vegetables, whole grains, lean meats, seafood, poultry, eggs, legumes, and low-fat dairy. Portion control may also be necessary - for older adults especially - as people may eat more food than they need.

It can be challenging to cook for a smaller family, so experts sometimes suggest cooking ahead and freezing portions to eat later when cooking is less appealing.

The particulars of this latest study seem to mirror the nutritional needs of older adults. However, the authors suggest that the addition of more protein may be the key to avoiding some of the unhealthful pitfalls that can take place when an older adult loses weight.

"This study suggests that a diet high in protein and low in calories can give seniors the health benefits of weight loss while keeping the muscle and bone they need for better quality of life as they age." - Lead investigator Kristen Beavers.

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Saturday

How Exercise Can Counter the Effects of Jet Lag

How Exercise Can Counter the Effects of Jet Lag

New research in The Journal of Physiology suggests that exercising at certain times of the day can alter the circadian rhythms, potentially offering a new therapy for jet lag and shift work.

Jet lag can lead to insomnia and fatigue, but exercise may help alleviate such disruptions to a person's body clock.

Circadian rhythms, which are "physical, mental, and behavioral changes that follow a daily cycle," regulate our bodies.

Light and darkness are the main factors that affect our circadian rhythms.

A cluster of nerve cells in the brain receives information about the amount of light through the optic nerves, "telling" our brains to make us sleepy by releasing the sleep hormone melatonin.

However, when we travel to a different time zone or work the night shift, we disrupt these circadian rhythms. Some of the adverse effects of such disruptions include insomnia and fatigue, trouble focusing, headaches, and gastrointestinal problems.

There are currently no treatments for the adverse effects of jet lag or shift work, so researchers are trying to devise novel therapies. For instance, one recent study has found that the retina contains some cells that secrete vasopressin, another hormone that helps regulate circadian rhythms.

Altering the vasopressin signaling pathway may one day lead to the manufacture of eye drops that could offset the effects of jet lag, but such treatments are still far from becoming a reality.

However, what if it was possible to treat jet lag without drugs? What if light was not the only factor that affects circadian rhythms?

Shawn Youngstedt, from the College of Nursing and Health Innovation and the College of Health Solutions at Arizona State University in Phoenix, and his colleagues asked themselves these questions.

Their research found that exercise may counter the negative effects of circadian rhythm disruption.

Exercise Delays or Advances the Body Clock

Youngstedt and his colleagues examined the effects of exercise on 51 "aerobically fit" participants aged 59-75 years and 48 study participants aged 18-30 years. They measured the participants' circadian rhythms and how exercise affected them for a period of 5.5 days. Specifically, the 99 volunteers all did 1 hour of moderate treadmill exercise for 3 consecutive days at one of eight different times during the day or night.

The scientists determined the participants' baseline body clock by analyzing their urine samples and determining their levels of melatonin.

The body releases melatonin in different amounts at different times of the day: The hormone peaks in the evening and drops in the morning. By taking samples from the volunteers every 90 minutes, the researchers identified the precise time when their melatonin rose and fell throughout the day.

Exercising at 7 a.m. or between 1 p.m. and 4 p.m. shifted the circadian rhythm to an earlier time, while engaging in exercise between 7 p.m. and 10 p.m. pushed the body clock back. Age or sex did not affect these results.

On the other hand, exercising between 1 a.m. and 4 a.m. or at 10 a.m. did not affect their melatonin levels.

Youngstedt comments on the findings, saying: "Exercise has been known to cause changes to our body clock. We were able to clearly show in this study when exercise delays the body clock and when it advances it."

"This is the first study to compare exercise's effects on the body clock, and could open up the possibility of using exercise to help counter the negative effects of jet lag and shift work." - Shawn Youngstedt.

However, the study authors caution that because the participants had higher fitness levels than the general population, the results may not extend to people who are less fit.

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Friday

Psychiatric Care Saved Me Says Richard Coles

Psychiatric Care Saved Me Says Richard Coles

Pop star-turned-vicar the Reverend Richard Coles has credited a mental health hospital for saving his life when he was 17.

The former Communards keyboard player said he was an inpatient at St Andrew's Healthcare in Northampton when he had an episode of clinical depression.

Mr Coles said he was coming to terms with his sexuality and "as a gay man in Kettering in 1978" at the time.

The care he received "literally saved my life", he said.

The former Strictly Come Dancing celebrity contestant said: "There really wasn't much sense of a life rich in possibilities.

"It was a much less tolerant world then than it is today and that was a real struggle. Coming here (St Andrew's) made a big difference to me."

Mr Coles, a broadcaster on BBC Radio 4's Saturday Live programme, visited St Andrew's Healthcare as part of LGBT (Lesbian, Gay, Bisexual and Transgender) History Month.

He said the care he received from two psychiatrists there helped put a stop to "all that internalised self-loathing" and gave him a sense that "this is an identity that's not necessarily a negative identity".

"I became determined, I wasn't going to live the narrow, mean and constrained life that was the best on offer.

"And I ran away to London and formed a new life and became an activist," he said.

Through access to media and music he said he "caught that rising tide of change".

Mr Coles was ordained into the Anglican priesthood in 2005 and is the vicar of Finedon in Northamptonshire.

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Celebrity Ads for Diet Aids Should Be Banned, Says Top Doctor

Celebrity Ads for Diet Aids Should Be Banned, Says Top Doctor

Social media companies should ban "damaging" celebrity-endorsed social media ads promoting weight loss aids, England's top doctor has said.

Some celebrities with large followings are promoting products such as diet pills and detox teas on social media.

Prof Stephen Powis, NHS medical director, argues these products have a damaging effect on the physical and mental health of young people.

He is also urging influential celebrities to act "responsibly".

Prof Powis said: "If a product sounds like it is too good to be true, then it probably is.

"The risks of quick-fix weight loss outweigh the benefits, and advertising these products without a health warning is damaging.

"Highly influential celebrities are letting down the very people who look up to them, by peddling products which are at best ineffective and at worst harmful.

"Social media companies have a duty to stamp out the practice of individuals and companies using their platform to target young people with products known to risk ill health," he said.

'Fires lit by other people'

Some influential celebrities have promoted weight loss aids for payment on social media, and this type of advertising is growing as brands realise how influential their posts are with young people.

The Competition and Markets Authority recently announced a clampdown on celebrities who do not clearly label their posts as being paid-for advertisements, but there are few rules around what they can promote.

NHS England's national mental health director Claire Murdoch told BBC Breakfast that the intention was not to "suppress business or comment on what good business looks like".

However, she expressed concern over the influence these celebrities had over young people at an "impressionable" stage in their lives.

"Both the celebrities themselves and these social media companies themselves should be more responsible," she added.

'A toxic influence'

Kim Kardashian West, who has 126 million followers on Instagram, was criticised for advertising appetite-suppressing lollypops last year. She later deleted the post.

In January, she posted an ad promoting meal replacement shakes.

Katie Price (1.9 million followers) has advertised an appetite suppressant on her Instagram page, as did Vikki Patterson (4.2 million followers) of TV shows Geordie Shore and Loose Women.

Lauren Goodger of The Only Way is Essex has also advertised diet aids.

Actress Jameela Jamil, who campaigns for body positivity, has described Kardashian West as a "terrible and toxic influence on young girls", and a meal replacement shake as "laxative teas."

Ms Jamil is the founder of the I Weigh social media campaign on Twitter and Instagram - where she encourages women to measure their value beyond their weight and looks.

Research from the National Citizens Service shows that at least one in four young people say that their appearance was the most important thing to them, with over half of girls feeling the pressure to be thinner, and a third of boys thinking they should be more muscular.

"Taking any substance which impacts the body, without proper medical advice and support, is a risk" said Prof Powis.

"Cosmetic treatments and get-thin-quick products which are readily and increasingly available and promoted, can be harmful if not used correctly."

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Is Breakfast Always a Good Idea?

Is Breakfast Always a Good Idea?

Breakfast may be the most important meal of the day, but eating it won't help you lose weight, research suggests.

Those who ate breakfast consumed 260 more calories per day and gained 1lb more than those who skipped it, a review of previous studies found.

But experts say a healthy breakfast can be a good source of calcium and fibre.
It has also been shown to improve concentration and attention levels, particularly in children.

Breakfast gives you energy, stops you snacking later in the day and supplies essential nutrients - so we are told.

Its reputation as the nutritional backstop to our day stems from observational studies showing a positive link between people eating breakfast and having a healthy weight.

But this new Australian research in the BMJ, which reviewed the results of 13 separate trials on breakfast eating, weight change and energy intake, found little evidence for those views.

The findings of the Monash University research team suggest that skipping breakfast might in fact be a good way to reduce total daily calorie intake.

They found that breakfast eaters consumed more calories overall and breakfast skippers did not have a greater appetite in the afternoon.

And they say caution is needed when recommending breakfast for weight loss in adults - because it could have the opposite effect.

However, the researchers added that there were limitations to their study.

What is a Healthy Breakfast?

  • For an energy boost - try an "apple pie" porridge, with cinnamon, or baked beans on wholemeal toast
  • For protein - try scrambled eggs with spinach on toast or low-fat Greek yoghurt with fruit and nuts
  • For a light bite - make a smoothie from tinned fruit, banana and spinach or mash avocado on toast
The participants in the studies were only followed for short periods - from between two and 16 weeks - and the difference in calorie intake between breakfast eaters and skippers was small.

The researchers concluded that working out the long-term effect of skipping or adding breakfast to diets still needed more research.

Calcium and Fibre Boost

Prof Kevin Whelan, dietetics expert and head of King's College London's nutritional sciences department, says we should not get too hung up on calorie intake first thing in the morning.

"This study does not say breakfast is bad for the health," he said.

"Breakfast is important for nutrient intake, such as cereals and milk which are good for calcium and fibre."

But the BMJ research did not look at this aspect of breakfast.

"We are not talking about breakfast being the cause of obesity," he said.

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Dentist 'Unfair' Fines Investigated by Watchdog

Dentist 'Unfair' Fines Investigated by Watchdog

The public spending watchdog is to investigate whether hundreds of thousands of people going to the dentist have been unfairly fined.

The National Audit Office is holding an inquiry into NHS penalty charges in England - applied to people alleged to be wrongly claiming free treatment.

The BBC had revealed many vulnerable people were being fined £100.

The British Dental Association (BDA) has warned that this is scaring poor families from going to the dentist.

The dentists' organisation says almost 430,000 penalty fines were issued last year - which they say is often "simply for ticking the wrong box on claim forms".

'Low Incomes and Elderly'

Many of the people facing fines, the dentists say, are "on very low incomes, the elderly, and those with learning difficulties".

The BDA says that when these fines for wrongfully claiming free treatment are challenged, about nine in 10 are overturned.

But dentists are worried that many people are so worried about the risk of being fined that they do not get dental treatment.


The BBC highlighted the concerns of many families who found that elderly relatives, or people with dementia or learning difficulties, were getting fined, even though they were entitled to free treatment.

The growing scale of the problem has begun to emerge - and also the impact on poorer patients.

According to the BDA, the number of dental visits from those entitled to free treatment has fallen by almost a quarter in the past four years.

Compared with five years ago, there has been a tenfold increase in the number of fines.

'Hostile Environment'

The National Audit Office is to examine how the NHS penalty charge system is being operated - how many are issued, entitlement to exemptions and the revenue generated from fines.

Charlotte Waite, the BDA's chair of the community dental services committee, welcomed the investigation - and said a simple error in an application form should not mean a £100 fine.

"The government's approach to penalty charges has hit hundreds of thousands of vulnerable patients, and encouraged millions more to miss out on care.

"Yes, we need a system to protect taxpayers' money, but that does not mean constructing a hostile environment for patients, many of whom have complex needs," said Ms Waite.

The Department of Health and Social Care has argued that everyone should have free NHS dental treatment if they are eligible.

But it has said that it is right for it to seek to recover money from anyone who wrongly claims free services.

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Tuesday

Cancer Cliches to Avoid: I'm Not 'Brave'

Cancer Cliches to Avoid: I'm Not 'Brave'

Fighter, warrior, hero - some of the terms you might see used to describe people with cancer.

But according to a new survey, for some with the illness the words are seen as inappropriate rather than uplifting.

The UK poll by Macmillan Cancer Support of 2,000 people who have or had cancer found "cancer-stricken" and "victim" were also among the least-liked terms.

The charity said it showed how "divisive" simple descriptions of cancer can be.

Calling a person's cancer diagnosis a "war" or a "battle" and saying they had "lost their battle" or "lost their fight" when they died, were other unpopular descriptions, according to the poll carried out by YouGov.

Articles in the media and posts on social networks were found to be the worst offenders for using such language.

The survey found a preference for factual words to describe people with cancer, their diagnosis, and when someone with the illness dies.

'I'm not inspirational'

Mandy Mahoney, 47, has incurable metastatic breast cancer.

The outreach support worker, from London, was initially diagnosed with breast cancer in 2011 and it has since returned five times.

She said: "I think cancer-speak can be quite negatively loaded - the brave, fighter, warrior and survivor standard descriptors put an awful lot of pressure on the newly diagnosed."

Mandy said she also objected to describing people as "losing their battle" with cancer.

"That confers that you didn't fight or gave up," she said.

Instead, she prefers "clear, factual language" and describes herself simply as "living with incurable cancer".

"I'm not brave or inspirational, I'm just trying to live the life I have left well," she added.

However, Craig Toley, who was diagnosed with thyroid cancer in 2016 and is now in remission, said he thought some of the more positive terms could be empowering.

The 31-year-old, who is a powerlifter in his spare time, says: "Language like 'fight', 'struggle', 'warrior' and 'battle' will be interpreted differently by different people.


"Personally, I found those words helped empower me a lot and made me think of my cancer as a challenge I needed to fight.

"Everyone likes the story of a fighter."

'Divisive words'

Karen Roberts, chief nursing officer at Macmillan Cancer Support, said: "These results show just how divisive and 'Marmite' simple words and descriptions can be.

"Cancer throws all kinds of things your way, and struggling to find the words, and the emotional turmoil caused when our friends and family don't get it 'right' only makes lives feel even more upended.

"By drawing attention to this we want to encourage more people to talk about the words they prefer to hear, and stop the damage that can be caused to people's wellbeing and relationships."

Mandy said it was not necessary for people to "swallow a textbook and come up with all of the key phrases" to talk to someone with cancer, and it is fine to not always know what to say.

"If you tell me it's awkward and you don't know what to say I will find a way to make that right for you, and actually on some occasions I might say 'we don't have to talk about it'.

"But just be real."

Macmillan Cancer Support has launched a campaign to highlight the challenges posed by a cancer diagnosis and the support available.

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Gene Modified Chickens 'Lay Medicines'

Gene Modified Chickens 'Lay Medicines'

Researchers at the University of Edinburgh's Roslin Institute have genetically modified chickens to produce human proteins in their eggs.

They hope the project will one day lead to lifesaving drugs that are much cheaper to make.

The team modified the genomes of the chickens so their eggs contain large amounts of high quality proteins.

Just three eggs contain a clinically significant dose, according to the scientists.

Initially the proteins will be used in research but laboratory tests have already found they work at least as well as equivalent drugs.

Protein-based therapies such as the cancer treatments Herceptin and Avastin can be effective where traditional drugs fail but they are highly expensive.

The new research - a collaboration between the institute and the university's spinout company Roslin Technologies - holds out the promise of a far cheaper production process.

We meet the medicine makers of tomorrow in a secure facility at the Institute.

Dozens of transgenic chickens are kept in rows of spacious pens.

Their job is straightforward enough: lay 300 eggs a year.

There are cockerels here too, something of a surprise to a townie like me.

Their purpose is twofold. Hens won't lay unless there's a cockerel in the vicinity.

Plus the males are required to make more transgenic chickens.

These creatures are not clones. New generations of protein producers are made in the conventional, biological way.

Professor Helen Sang of the Institute says it's a cost effective way of scaling up production:

"If you want more eggs you just need more birds."

"That's why in this pen we have a cockerel - and he can produce an awful lot of children in a short time.

"So we can produce a lot of hens in a short period if we want to bulk up the supply of the drug."

In a laboratory away from the cacophony of the chicken shed, Dr Lissa Herron of Roslin Technologies produces a tray of brown eggs that would grace any breakfast table.

But these ones will never enter the food chain. "It's quite old fashioned initially," she says.

"We just crack the egg. I've become quite adept at cracking eggs over the years."

The golden yolk is put to one side unneeded.

It's the egg white that contains the treasure: large quantities of medically important proteins.

"These proteins are really, really expensive to produce," she says, "because you can't just synthesise them in a chemistry lab.

"You need a living system to manufacture them because proteins are very large molecules, very complex and they need all of the machinery of a cell to make them and fold them properly."

So far the the chickens have been genetically modified to produce two types of protein.

One is Macrophage-CSF. It is being is being developed as a therapy that stimulates damaged tissues to repair themselves.

It is being produced in human and pig versions.

The other is called Interferon Alfa-2A.

"This is a human protein that is native in our bodies - it's expressed as part of our immune system," Dr Herron says.
"It has antiviral properties. It's also been found that is has some anti-cancer properties.

"It's a protein that is used in the clinic today - or has been for quite some time - for treating hepatitis and certain cancers."

Veterinary Medicine

As with all research into promising treatments there is a caveat. It can take decades of further research and testing before a breakthrough becomes a medicine.

However treatments for rare, so-called 'orphan' diseases can be fast-tracked - and drugs for animals tend to come on the market even more quickly.

By reducing the cost of protein therapies the new technique could create affordable treatments for farm animals and pets, opening up a new market in the veterinary sector.

Dr Herron knows just how effective protein therapies can be: she received an existing drug for inflammatory bowel disease.

"It was a pretty incredible thing," she says. "I went from Friday, when I was probably going to have my entire bowel removed, to Monday going home.

"It's pretty impressive type of stuff we can do with some of these drugs.

"So hopefully we can get these out there and treat some of these really difficult illnesses."

The team are confident they can expand the range of proteins chickens can lay.

The technique used to introduce the new genes into chicken DNA employed a lentivirus to deliver the payload.

It is long established but involves trial and error before the genes find their desired target.

The newer CRISPR/Cas method is expected to allow much more precise editing.

The researchers received strategic funding from the Biotechnology and Biological Sciences Research Council and published their findings in the journal BMC Biotechnology.

The chickens themselves are unaffected by the presence of human proteins in their systems.

Living in conditions superior to those of battery hens, they just go on laying eggs as normal.

EU regulations against GM organisms in the food chain mean neither they nor their eggs will end up on your plate.

But they could be pioneers in producing better and cheaper medicines.

Cheaper because they literally work for chicken feed.

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Video: Preventing Shingles

Video: Preventing Shingles

If you've had chickenpox, you're at risk for getting shingles, a very painful and potentially debilitating disease. Nearly one in three Americans will get shingles, and older adults are more at risk.

But adults age 50 and older can get protection from shingles simply by getting the shingles vaccine. Watch this public service announcement below to learn more.



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Wednesday

Two Dead After Pigeon Dropping Infection at Hospital


Two patients have died after contracting a fungal infection caused by pigeon droppings at the Queen Elizabeth University Hospital.

NHS Greater Glasgow and Clyde said an elderly patient died but from an unrelated cause.

Another infected patient has also died but the factors contributing to the death are still being investigated.

A non-public room, thought to contain machinery, was identified as a likely source. An investigation is under way.

A NHSGGC spokesman said: "Our thoughts are with the families at this distressing time.

"Due to patient confidentiality we cannot share further details of the two cases.

"The organism is harmless to the vast majority of people and rarely causes disease in humans."

NHSGGC confirmed a small number of vulnerable paediatric and adult patients are receiving medication to protect them against the airborne infection, which is a Cryptococcus species.

Portable HEPA air filter units have been installed in specific areas as an additional precaution.

Earlier on Saturday Teresa Inkster, lead consultant for infection control, said: "Cryptococcus lives in the environment throughout the world. It rarely causes infection in humans.

"People can become infected with it after breathing in the microscopic fungi, although most people who are exposed to it never get sick from it.

"There have been no further cases since the control measures were put in place."
Ms Inkster said experts are continuing to monitor the air quality.

She added: "It remains our priority to ensure a safe environment for patients and staff."

'Very unusual'

Prof Hugh Pennington, of Aberdeen University, said he was surprised to learn of the infection.

The epidemiologist said: "It is very unusual in the UK.

"It is quite common in other parts of the world, particularly in tropical parts and in the US and in countries like that, where they have more problems with this particular kind of fungus."

Prof Pennington said people with weak immune systems are most at risk.

He added: "When it gets into the blood stream a lot of people have fairly straightforward infections and it settles in the lungs but the big problem with this is that it can cause meningitis and, as we know, meningitis can be a very serious infection."

Prof Pennington said anti-fungal drugs are used to treat the infection but warned it can be fatal if it is not diagnosed.

Airborne infection

The expert said a key priority would have been stopping the airborne infection from entering the hospital's ventilation system.

He added: "Obviously they have stopped the pigeons getting into the machine room.
"It surprises me slightly that there was any there in the first place."

During the investigation, a separate issue arose with the sealant in some of the shower rooms.

NHSGGC said repairs are underway and our maintenance team are working to remedy this issue as quickly as possible with the minimum disruption.

As a further precaution, a specific group of patients are being moved within the hospital due to their clinical diagnosis and ongoing treatment.

The £842m QEUH opened in April 2015 and featured in the BBC series Scotland's Superhospital.

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