Sunday 28th February 2016- BBC News: Ebola nurse Pauline Cafferkey discharged from hospital

‘Scots nurse Pauline Cafferkey has been discharged from a London hospital after being treated there for a third time since contracting Ebola.

The 40-year-old from South Lanarkshire was flown to the Royal Free Hospital on Tuesday after being admitted to Glasgow’s Queen Elizabeth Hospital.

The Royal Free said she had been discharged and was “not infectious”.

Ms Cafferkey was treated there twice in 2015 after contracting Ebola in Sierra Leone the previous year.

A spokesman for the Royal Free Hospital said: “Pauline Cafferkey has today been discharged from the care of the Royal Free Hospital following her admission due to a complication related to her previous infection by the Ebola virus.

“We can confirm that Pauline is not infectious. The Ebola virus can only be transmitted by direct contact with the blood or bodily fluids of an infected person while they are symptomatic.”

Health Secretary Jeremy Hunt later tweeted: “It’s fantastic news that Pauline Cafferkey has been discharged from hospital. Outstanding care again from @RoyalFreeNHS #NHSheroes.”

The nurse, from Halfway, Cambuslang, contracted the virus while working as part of a British team at the Kerry Town Ebola treatment centre.

She spent almost a month in isolation at the Royal Free at the beginning of 2015 after the virus was detected when she arrived back in the UK.

Ms Cafferkey was later discharged after apparently making a full recovery, and in March 2015 returned to work as a public health nurse at Blantyre Health Centre in South Lanarkshire.

In October last year it was discovered that Ebola was still present in her body, with health officials later confirming she had been diagnosed with meningitis caused by the virus.’

Related Articles:

Ebola nurse Pauline Cafferkey discharged from hospital

Ebola nurse Pauline Cafferkey discharged from hospital- The Telegraph

Ebola nurse Pauline Cafferkey discharged from hospital- The Guardian

Saturday 27th February 2016- The Guardian: Decayed teeth removed from 128,000 children in England since 2011

‘Tens of thousands of children have had decaying teeth removed in hospitals in England, according to the latest figures, which show an increase for the fourth year in a row.

There has been a rise of almost 10% in child hospital admissions for severe tooth decay in England over a four-year period, with the report’s authors pointing out “a strong correlation between area deprivation and the rate of tooth extraction”.

More than 128,000 children aged 10 and under have needed at least one removed since 2011, often in cases where the decay may have been preventable.

There were 14,445 admissions of children aged five and under between April 2014 and March the following year, and a further 19,336 cases of six- to10-year-olds having teeth taken out in hospital in the same period. More boys than girls were likely to have suffered from severe tooth decay.

The rate of tooth extraction among the most deprived children is almost five times that for those from the least deprived decile, according to the statistics analysed by the Health and Social Care Information Centre.

In Yorkshire and the Humber, the tooth extraction rate was more than five times that for the east of England. London had the most children who needed to be admitted to hospital for severe tooth decay, with 8,362 having teeth removed.

Prof Nigel Hunt, the dean of the dental surgery faculty at the Royal College of Surgeons, said the 9.81% increase was unacceptable.

“Not only is tooth decay distressing to children and parents, it has serious social and financial implications,” he said. “The need for tooth extraction continues to be the number one reason why five- to nine-year-old children are admitted to hospital. This issue urgently needs to be addressed, especially since 90% of tooth decay is preventable.”

Related Articles:

Decayed teeth removed from 128,000 children in England since 2011

Tooth decay still on the rise among English children- BBC News

Friday 26th February 2016- The Independent: Asthma: Half of children diagnosed with the respiratory disease may not have it, study suggests

‘More than half of the children being treated for asthma might not actually have the condition, new research suggests.

A study, published in the British Journal of General Practice, found 53 per cent of children had no clinical signs of asthma despite being diagnosed at one of four medical centres in the Netherlands, whose healthcare system is widely regarded as one of the best in Europe.

In the UK last year, researchers found that a third of adults diagnosed with asthma did not actually have it.

Dr Ingrid Looijmans-van den Akker, one of the scientists behind the Dutch research, told The Daily Telegraph: “Over-diagnosis of asthma was found in more than half of the children, leading to unnecessary treatment, disease burden, and impact on their quality of life.

“Previous studies have indicated that asthma is over-diagnosed in children. However, the scale of the over-diagnosis has not been quantified.

“Only in a few children was the diagnosis of asthma confirmed using lung function tests, despite this being recommended in international guidelines. Over-diagnosis gives rise to over-prescription and incorrect use of medication, and to anxiety in parents and children.”

The UK’s National Institute of Clinical Excellence (Nice) has warned that doctors have too often tended to diagnose asthma based on a history of wheezing, coughs and other breathing problems, rather than clinical tests.

Professor Mark Baker, director of clinical practice at Nice, said it was developing new advice on how to properly diagnose the condition.

“As part of this work, Nice is inviting GP practices to take part in a project to check the feasibility of some diagnostic tests that Nice proposes to recommend,” he said.’

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Asthma: Half of children diagnosed with the respiratory disease may not have it, study suggests

Half a million children with asthma may not actually have condition- The Telegraph

Friday 26th February 2016- The Telegraph: First drug to reverse Huntington’s disease begins human trials

‘A drug which appears to reverse Huntington’s disease is being trialled in humans after proving successful in monkeys and mice.

The new drug, called IONIS-HTTRx, silences the gene known to be responsible for the production of a protein which causes Huntington’s.

The disease is a hereditary condition which damages nerve cells in the brain and effects around 7,000 people in Britain. It causes uncontrolled movements, loss of intellectual abilities, emotional problems and eventually death.

Now scientists have shown that it is not only possible to halt the disease but to reverse the damage.

“It is very exciting to have the possibility of a treatment that could alter the course of this devastating disease,” said clinical study principal investigator Dr Blair Leavitt, of the University of British Columbia in Vancouver.

“Right now we only have treatments that work on the symptoms of the disease.”

Huntington’s is caused by a mutated HTT gene, and everyone who inherits the genetic defect will eventually develop the disease.

Researchers have been trying to develop a drug which acts like a dimmer switch, turning the gene down so that it can no longer produce the devastating protein which causes brain damage.’

‘When they tested IONIS-HTTRx on mice with the disease their motor function improved within a month and within two months their health was restored to normal. In monkeys the drug was found to decrease the HTT protein throughout the central nervous system by 50 per cent.

The drug is delivered into the cerebral spinal fluid via lumbar injection, as antisense drugs do not cross the blood brain barrier – a protective sheath that prevents toxins entering the brain.

The drug is now being trialled in humans in low doses to check that it is safe for larger trials into its efficacy to begin.

The research was presented at the American Academy of Neurology’s 68th Annual Meeting in Vancouver, Canada, April 15 to 21, 2016.’

See:

First drug to reverse Huntington’s disease begins human trials

Thursday 25th February 2016- The Independent: Pancreatic cancer is four different diseases, study finds

‘A new study which has shown that pancreatic cancer is four separate diseases has been hailed as “incredibly exciting.”

The team at the University of Glasgow said the study was as a “launch pad” for finding new treatments for the disease.

Around 8,000 people in the UK are diagnosed with the cancer which affects the large gland in the digestive system each year. It is particularly difficult to diagnose as it does not show symptoms in the early stages.

The way in which pancreatic cancer is treated has not developed greatly for two decades, said Dr Peter Bailey, one of the study authors, and compared current methods to “hitting the disease with a mallet with your eyes closed.”

Around a fifth of those with the disease survive more than a year after being diagnosed, while less than 5 per cent living after five years, and 1 per cent after a decade.

The team at the University of Glasgow studied around 456 pancreatic cancer tumours for the research published in the journal ‘Nature’.

Scientists were able to categorise the disease into four different sub-types: squamous, pancreatic progenitor, immunogenic and ADEX.

Professor Sean Grimmond, who led the study, said: “This study demonstrates that pancreatic cancer is better considered as four separate diseases, with different survival rates, treatments and underlying genetics.”

“Knowing which sub-type a patient has would allow a doctor to provide a more accurate prognosis and treatment recommendations.

He explained that cancer drugs that doctors use or are in development can target the disease which are similar to other forms of cancer.

For example, some types of pancreatic cancer are associated with mutations normally found in colon cancer or leukaemia, he said.

Pancreatic Cancer UK described the findings as “incredibly exciting”.

Leanne Reynolds, head of research at the charity, said the findings meant that in the future “the right patients can be given the right treatment at the right time”.’

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Pancreatic cancer is four different diseases, study finds

Major insight into killer pancreatic cancer- BBC News

Scientists discover pancreatic cancer is four separate diseases- The Guardian

Thursday 25th February 2016- The Guardian: Lab-created sperm breeds healthy mice, raising hopes for end to male infertility

‘A handful of healthy mice made from sperm cells created in the lab have been hailed as a milestone in research that could ultimately provide new treatments for male infertility.

Scientists in China created the mice by fertilising normal mouse eggs with early-stage sperm cells that were manufactured from embryonic stem cells plucked from the animals.

To make the sperm, the team nudged mouse stem cells through a complex series of steps known as meiosis that must be performed with extreme care to ensure the sperm develop properly.

Despite years of work, scientists have never managed to pull off the same trick with human stem cells, but the latest study could provide fresh impetus to the effort, said Jiahao Sha, director of the Laboratory of Reproductive Medicine at Nanjing Medical University in China.

The creation of sperm and eggs – known as germ cells – for use in IVF raises particular safety issues, because any faults in their genetic material could harm not only the children born from the treatment, but all their future descendants.

“If it works, human germ cells could possibly be produced. However, in the current stage, ethics should be concerned, and any possible risks ruled out,” said Sha, who led the team

The scientists believe that the cautious, stepwise production of the sperm cells was crucial for the mice to be born healthy and fertile. The mice went on to mate and have fertile offspring of their own, Sha said.’

‘Independent scientists welcomed the landmark achievement but cautioned that the creation of human sperm to treat infertile men was a distant prospect fraught with concerns over safety, ethics and legality.’

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Lab-created sperm breeds healthy mice, raising hopes for end to male infertility

Toward Making Sperm in the Lab- The Scientist

Lab-grown sperm makes healthy offspring- BBC News

Sperm grown in lab could allow infertile men to have children- The Telegraph

Wednesday 24th February 2016- The Guardian: Radical cancer treatment seeks to control rather than destroy tumours

‘A radical approach to cancer treatment which keeps tumours under control rather than destroying them completely may be more effective than conventional therapies, scientists say.

The idea draws on Charles Darwin’s 150-year-old theory of evolution and recasts tumours as diverse ecosystems of cells which can be manipulated to prevent them from growing out of control.

The strategy is highly experimental and has only been tested in mice, but successful trials in humans could usher in a transformation in cancer care, where patients live healthy lives with tumours that are constantly kept in check by low doses of medicine.

Routine cancer treatment assumes that patients do best when a therapy kills off the maximum number of malignant cells in their bodies. But tumours are collections of different cells and some are more resistant to drugs than others. A dose of chemotherapy will typically leave drug-resistant cells behind. Unencumbered by their neighbours, they can rapidly grow back when the treatment stops.

Scientists in the US wondered what would happen if anticancer drugs were used to shrink tumours without destroying the diversity of cells inside them. They hoped that the surviving cancer cells would stop more aggressive, drug-resistant ones from taking over, just as grass can prevent moss running wild in a garden.

Writing in the journal Science Translational Medicine, Robert Gatenby at the H. Lee Moffitt Cancer Center in Tampa, Florida, describes how his team tested the idea with the chemotherapy drug paclitaxel (or taxol) in mice with two different forms of breast cancer.

When the mice were given standard chemotherapy, their tumours shrank, but grew back as soon as the treatment ended. For the new therapy, mice were given initially high doses of drugs followed by ever lower doses. The strategy appeared to be more effective than standard treatment. Giannoula Klement, a cancer specialist at Tufts University School of Medicine in Boston, who was not involved in the work, said that in about 60% of the mice, the cancer treatment could be withdrawn completely with no further growth of the tumours.

In an accompanying article, Klement argues that to beat cancer, it must be considered as an ecosystem of different cells. “The likelihood that a ‘magic bullet’ against cancer is going to be found is nil. If we have learned anything from the eco-evolutionary model it is that unless we respect these eco-evolutionary laws, we will continue to play a cat and mouse game with cancer,” she writes.

Instead of eradicating cancer, the new goal for doctors needs to be prevention of cancer disease, she adds. “We need to stabilise tumour growth and enable gradual, controlled regression over time.”’

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Radical cancer treatment seeks to control rather than destroy tumours

Don’t kill cancer, learn to live with it, say scientists- The Telegraph

Saturday 6th February 2016- The Independent: Zika: Colombia links virus with three Guillain-Barre nerve disorder deaths

‘Colombian health officials have suggested there is a connection between the Zika virus, a rare nerve disorder and the deaths of three Colombians, as the disease continues to spread rapidly throughout the Americas.

The announcement, made on Friday, is the first time government health officials have directly blamed the mosquito-borne virus for causing deaths.’

‘Colombian Health Minister, Alejandro Gaviria, said: “There is a causal connection between Zika, Guillain-Barre and the death of three Colombians, one in San Andres and another two in Turbo, Antioquia.”

The three patients died last week after being treated at a clinic in Medellin, said the minister, Reuters reports.

The head of Colombia’s National Heath Institute, Martha Lucia Ospina, said. “We have confirmed and attributed three deaths to Zika.”’

‘“In this case, the three deaths were preceded by Guillain-Barre syndrome.”

Guillain-Barre is a rare disorder in which the body’s immune system attacks part of the nervous system. It is not usually fatal but can cause paralysis and muscle weakness.

Cases of the syndrome have increased in tandem with the Zika outbreak, sparking suspicions it is a complication of the virus, also blamed for causing microcephaly or brain damage in babies born to infected mothers.

However, scientists have not proven Zika causes either condition.’

Related Articles:

Zika: Colombia links virus with three Guillain-Barre nerve disorder deaths

Colombia links Zika to rare nerve disorder deaths- BBC News

Colombia confirms first three deaths of patients infected with Zika virus- The Guardian

Friday 5th February 2016- The Independent: Zika: Virus passed on during blood transfusions in Brazil

‘The mosquito-borne Zika virus has been passed on to two people via blood transfusions, according to health officials.

The two unrelated incidents are believed to be the first examples of the virus being contracted during the procedure. ‘

‘Zika is a relatively mild virus which does not cause symptoms in four out of five patients, however the World Health Organisation has labeled it as a global health emergency due it its suspected links to microcephaly – a condition believed to cause brain damage and the appearance of a shrunken head in babies.

A gun-shot victim and a transplant patient both tested positive for Zika after receiving blood transfusions from different donors, Brigina Kemp, a health official in the Brazilian city of Campinas, told The Associated Press.

Doctors at the University of Campinas hospital became concerned about Zika when the gunshot victim had abnormal blood work after spending months at the facility. During this time, he received transfusions from 18 donors between February and May 2015 when he died.

However, staff suspected that dengue was behind the abnormalities as the region was experiencing an outbreak at the time, according to Kemp. However tests showed the patient was negative for dengue and the blood was shelved.

When a transplant patient tested positive for Zika, tests proved that the gun-shot victim had also contracted the virus.

Days after giving blood, the donors were found to have suffered from Zika.’

See:

Zika: Virus passed on during blood transfusions in Brazil

Thursday 4th February 2016- The Telegraph: Team GB athlete dies from meningitis after being told by A&E doctor she had stomach bug

‘A young Great Britain athlete died from meningitis just hours after a junior doctor on his first week in A&E wrongly diagnosed a stomach bug, an inquest heard.

Ellie Penrose, a promising 18-year-old triathlete, was taken to hospital by her family after complaining of a headache and sensitivity to light.

She was seen by newly-qualified Dr Don Hettiarachchi who diagnosed gastroenteritis and dehydration and sent her home with paracetamol and ibuprofen.

But an inquest heard she was “inappropriately discharged” from Hull Royal Infirmary, in East Yorkshire, after the “failure in care”.’

‘Hours later, her parents Tom and Pauline dialled 999 after finding her critically ill on her bed at their home. She was taken to hospital, but died later the same day from “overwhelming sepsis” caused by meningococcal septicaemia.

Hours before she died last August, Miss Penrose discovered she had excelled in her A-levels and was destined for university.

Dr Hettiarachchi admitted to the Hull inquest he was “not 100 per cent sure” of the root cause of Miss Penrose’s illness when he saw her in the hospital at 3am on August 12 last year.

With no consultant available, he consulted with fellow trainee Dr Ayman Ghoneim in a corridor before discharging her.

Coroner Professor Paul Marks asked if he had considered meningitis and Dr Hettiarachchi replied: “I did. When I examined her there was no rash. There was blotching on her face. I felt it was more viral.’

‘Questioned by the Penrose family’s lawyer, Dr Hettiarachchi added: “I did not treat it as meningitis because I felt it didn’t fit with the general picture.”

Asked if he would have done anything differently, he replied: “Lots of things. I would have consulted with a registrar or above.”

Dr Hettiarachchi accepted he did not highlight key observations – crucially, Miss Penrose’s high blood pressure, low pulse rate and skin blotching – to Dr Ghoneim, but denied a claim that he had already reached a diagnosis.’

Related Articles:

Team GB athlete dies from meningitis after being told by A&E doctor she had stomach bug

Team GB triathlete Ellie Penrose died after her meningitis was misdiagnosed as stomach pains, inquest hears- The Independent

Triathlete died after doctor failed to diagnose meningitis- The Guardian