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        <title>Fergus Walsh</title>
        <link>http://www.bbc.co.uk/news/correspondents/ferguswalsh</link>
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        <copyright>Copyright: (C) British Broadcasting Corporation</copyright>
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        <description>A focus on the medical and health issues of the day</description>
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                <title>Time-lapse imaging 'improves IVF'</title>
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		           		<p>Time-lapse imaging which takes thousands of pictures of developing embryos can boost the success rate of IVF, according to British research.</p>
		                      
		           		<p>The method, reported in Reproductive BioMedicine Online, can be used to select embryos at low risk of defects.</p>
		                      
		           		<p>Scientists at the CARE fertility group say such informed selection can improve birth rates by 56%.</p>
		                      
		           		<p>Other experts say the result is exciting, but the study of 69 couples is too small to be definitive.</p>
		                      
		           		<p>The research followed the couples at the CARE fertility clinic in Manchester last year, when 88 embryos were imaged and implanted.</p>
		                      
		           		<p>The embryos were put into an incubator and imaged every 10-20 minutes.</p>
		                      
		           		<p>Continual embryo monitoring through time-lapse imaging is aimed at selecting those with the lowest risk of aneuploidy - where the cells have chromosome abnormalities. Aneuploidy is the single biggest cause of IVF failure.</p>
		                      
		           		<p>But this form of embryo screening is a predictive rather than diagnostic tool.</p>
		                      
		           		<p>Couples at high risk of passing on a chromosomal abnormality may prefer to have Pre-implantation Genetic Screening. This invasive test removes cells from the early embryo for analysis. It costs around £2,500 on top of the £3,000 charged for conventional IVF.</p>
		                      
		           		<p>The researchers classified the embryos as low, medium or high risk of chromosome abnormalities based on their development at certain key points.</p>
		                      
		           		<p>Eleven babies were born from the low risk group (61% success rate) compared to five from the medium risk group (19% success rate) and none from those deemed high risk.</p>
		                      
		           		<p>&quot;In the 35 years I have been in this field this is probably the most exciting and significant development that can be of value to all patients seeking IVF,&quot; said Prof Simon Fishel, managing director of CARE Fertility Group.</p>
		                      
		           		<p>&quot;This technology can tell us which embryo is the most viable and has the highest potential to deliver a live birth - it will have huge potential. This is almost like having the embryo in the womb with a camera on them.&quot;</p>
		                      
		           		<p>In standard IVF, embryos are removed from the incubator once a day to be checked under the microscope. This means they briefly leave their temperature-controlled environment and single daily snapshots of their development are possible.</p>
		                      
		           		<p>Using the time-lapse method embryos don't leave the incubator until they are implanted allowing 5,000 images to be taken.</p>
		                      
		           		<p>&quot;Removing embryos from the incubator potentially exposes them to damage, so it must be a good thing to be able to look at the pattern of development over time.</p>
		                      
		           		<p>&quot;These results are very interesting but this is is a very small study and any interpretation of the findings must be made with caution as we are dealing with the hopes and expectations of patients,&quot; said Dr Virginia Bolton from the assisted conception unit at Guy's and St Thomas' NHS Foundation Trust.</p>
		                      
		           		<p>Sheena Lewis, professor of reproductive medicine at Queen's University, Belfast, said: &quot;This may well be the technique we have been waiting for to improve embryo selection and thus success in fertility treatment.</p>
		                      
		           		<p>&quot;However, this is a small study with just 46 embryos being followed through to birth. Much more research will be needed before this becomes a routine clinical tool.&quot;</p>
		                      
		           		<p>Around a dozen private and NHS clinics are using time-lapse embryo imaging. It costs around £750 in addition to about £3,000 for IVF.</p>
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		        </description>
                <link>http://www.bbc.co.uk/news/health-22559247</link>
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                <pubDate>Fri, 17 May 2013 02:49:29 +0100</pubDate>
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                <title>Coronavirus threat 'remains low'</title>
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		           		<p>The emergence of the novel coronavirus is a reminder of the potential threat we face from emerging diseases. A decade ago hundreds of people were killed by severe acute respiratory syndrome (SARS).</p>
		                      
		           		<p>Although the novel coronavirus is from the same large family of pathogens as SARS, it is very different. And although media reports usually mentions the new virus and SARS in the same breath it is worth pointing out that coronaviruses also produce infections like the common cold.</p>
		                      
		           		<p>Crucially the new virus seems hard to catch and is difficult to spread. Had it been otherwise there would have been far more cases.</p>
		                      
		           		<p>The World Health Organization says there have been 34 confirmed cases since September 2012.</p>
		                      
		           		<p>That does not mean the threat from this virus should be ignored. If you are unlucky enough to get infected the odds are not good. More than half the patients with confirmed infection have died and others remains seriously ill.</p>
		                      
		           		<p>The respiratory illness causes pneumonia, can attack the kidneys and other organs.</p>
		                      
		           		<p>The reason why the virus is in the news is because the WHO has said there is more evidence of person-to-person transmission. A patient who was being treated for the infection in northern France appears to have passed on the virus to another man who had been sharing a hospital room with him. Both are now being cared for in isolation.</p>
		                      
		           		<p>In February there was a family cluster of three cases in England. A man who had been travelling in Saudi Arabia returned to the UK and apparently passed on the infection to his son and another family member. Both he and his son died. The third member of the family recovered.</p>
		                      
		           		<p>Both the French and English cases suggest the virus is not very contagious and requires close proximity. Health officials in England traced up to 100 people who had been in contact with the man who returned from the Middle East, and none apart from family members got the virus.</p>
		                      
		           		<p>&quot;We are right to be concerned about the reporting of transmission from person-to-person, but there is absolutely no reason to panic.</p>
		                      
		           		<p>&quot;The 'super-spreading' events, in which one person infects several dozen people at a time (as was seen with SARS coronavirus), do not seem to be happening with this coronavirus&quot; said Prof Peter Openshaw, Director of the Centre for Respiratory Infection, Imperial College London.</p>
		                      
		           		<p>But that does not mean there is any room for complacency. A fourth UK case - a man who acquired the infection in the Middle East - has been in hospital in London since September. The sheer virulence of the infection, which can cause multi-organ failure, means it must be regarded a potent threat.</p>
		                      
		           		<p>The virus is thought to have originated in bats, but how the initial infection gets passed to humans remains a mystery. It is probable that it has an animal source, but whether it spreads from contaminated food or something else in the environment is unknown. Until scientists can establish this route of infection they can't initiate measures to try to eradicate the virus.</p>
		                      
		           		<p>&quot;The most important goal remains to locate the source of infection so that measures to minimise contact can be taken&quot;, said Prof Ian Jones, Professor of Virology, University of Reading.</p>
		                      
		           		<p>So for the moment this novel coronavirus remains a dangerous but thankfully very rare infection.</p>
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		        </description>
                <link>http://www.bbc.co.uk/news/world-europe-22516386</link>
                <guid isPermaLink="true">http://www.bbc.co.uk/news/world-europe-22516386</guid>
                <pubDate>Mon, 13 May 2013 17:41:41 +0100</pubDate>
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                <title>Should we worry about H7N9? </title>
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		           		<p>There is a new disease in town - at least there is if you live in eastern China. Long after most people had lost interest in - and the media had stopped writing about - H5N1 bird flu, we now have to get used to another assortment of letters and numbers. So should we all worry about H7N9?</p>
		                      
		           		<p>&quot;Yes and no&quot; seems to sum up the view of experts. Yes, because of the potential of flu viruses to cause global disease outbreaks - pandemics. No, because the virus is still confined to China and has no ability at present to transmit between humans.</p>
		                      
		           		<p>The facts of the new virus are simply put. In the space of one month more than 100 people have been infected in China. One in five has died and many more are seriously ill in hospital. It causes pneumonia and can lead to multi-organ failure.</p>
		                      
		           		<p>The virus originated in chickens and those who have fallen ill either attended live poultry markets or had close contact with infected birds.</p>
		                      
		           		<p>&quot;I think we're concerned because we have to prepare. Alarmed? No. The virus in humans is still confined to one region of China. It's got a high population but it still seems to be solely animal to human infection and it is not spreading between humans,&quot; said Prof John McCauley, director of a World Health Organization (WHO) collaborating centre in the UK.</p>
		                      
		           		<p>For years virologists and the WHO warned - in often apocalyptic terms - about the threat posed by H5N1. The Hs and the Ns are the surface proteins on the virus and give the different subtypes their name. H5N1 has been infecting and killing humans since 1997 - 628 cases and 374 deaths.</p>
		                      
		           		<p>H5N1 no longer makes the international headlines but already this year it has caused eight deaths in Cambodia. But thankfully it is still largely a disease of birds and has does not transmit easily between humans.</p>
		                      
		           		<p>That does not mean that H5N1 or H7N9 could never become airborne human infections; last year scientists showed that it would take around five mutations for bird flu to do just that. H7N9 has already undergone two of the mutations needed in the space of a month. But whether it will go any further is impossible to predict.</p>
		                      
		           		<p>&quot;It's like rolling the dice or winning the lottery. The more you do it, the more likely the mutations are to crop up and therefore limiting the number who are getting infected by this virus at the moment is the best thing that we can do to minimise the chance that this virus could ever turn into a pandemic,&quot; said Prof Wendy Barclay, chair of influenza virology, Imperial College London.</p>
		                      
		           		<p>Influenza experts have to tread a fine line between alerting the public and alarming them.</p>
		                      
		           		<p>&quot;We have been waiting for human to human transmission of H5N1 for years. But that doesn't mean it won't happen tonight or tomorrow. We have to be honest and open that we can't predict whether or when that will happen,&quot; said Prof Jeremy Farrar, director of the Wellcome Trust major overseas programme in Vietnam.</p>
		                      
		           		<p>Unlike H5N1, the new virus does not cause illness in birds, making it very difficult to identify infected flocks. International flu experts have praised the Chinese authorities for the way they have shared information about this outbreak.</p>
		                      
		           		<p>Many people will be sceptical about the risk of a flu pandemic after the 2009 swine flu outbreak turned out less serious than feared. But pandemics have killed millions in the past - so the essential work to create a vaccine will continue and to track the H7N9 virus will continue.</p>
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                <link>http://www.bbc.co.uk/news/health-22370895</link>
                <guid isPermaLink="true">http://www.bbc.co.uk/news/health-22370895</guid>
                <pubDate>Wed, 01 May 2013 22:13:26 +0100</pubDate>
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                <title>Why do so many people want cosmetic procedures?</title>
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		           		<p>It would seem that more and more of us are opting for a bit of help to slow the appearance of ageing.</p>
		                      
		           		<p>The idea of growing old gracefully - wrinkles and all - seems anathema to a growing number of Britons.</p>
		                      
		           		<p>The cosmetic procedures industry is booming. It has undergone an estimated five-fold increase in turnover in a decade. At any period that would be astounding growth - in the teeth of a recession it is all the more astonishing.</p>
		                      
		           		<p>In particular, there has been a surge in non-surgical treatments, such as dermal fillers and Botox.</p>
		                      
		           		<p>An independent review has revealed a shocking lack of regulation over these 'injectables', and it called for a range of measures to protect patients.</p>
		                      
		           		<p>So who is having a &quot;bit of work&quot; done?</p>
		                      
		           		<p>&quot;Our average patient is aged 35-55,&quot; said Pat Dunnion, chief operating officer with Transform.</p>
		                      
		           		<p>&quot;People want to look good - you pay to go to the gym, so why not pay to improve your looks? The treatments are more accessible and affordable than ever.&quot;</p>
		                      
		           		<p>Transform is the UK's biggest cosmetic surgery provider, with 24 clinics and two hospitals. It has a turnover of nearly £40m and has seen its non-surgical procedures double in just four years.</p>
		                      
		           		<p>Karen Rowing, 45, from Essex, is one of their patients: &quot;Everybody where I live wants to look good - even people aged 21, 22 are having treatment.</p>
		                      
		           		<p>&quot;I tell them to wait until they are my age but it's a battle of wills - everybody wants to compete against one another.&quot;</p>
		                      
		           		<p>Karen agreed to let us film her dermal filler treatment, which lasted about 25 minutes and cost £600. Years of filming surgery has left me fairly unsqueamish, but I imagine some people might find wince at having the fillers injected deep under the facial skin.</p>
		                      
		           		<p>Karen wanted to lessen the appearance of lines on her face, and took it all in her stride: &quot;There was some discomfort, but nothing to scream about. And I'm very pleased with the result - very natural looking.&quot;</p>
		                      
		           		<p>These lunch-hour lifts are proving increasingly popular. Karen Rowing said she had had Botox in her lunch-break and after the dermal filler treatment would be going home to pick up her children from school.</p>
		                      
		           		<p>The availability of non-surgical treatments has helped to normalise cosmetic procedures, fuelled by the celebrity culture which pervades much of the media.</p>
		                      
		           		<p>Done well, cosmetic procedures are intended to give a younger, more vital look. Done badly they can leave people looking puffed up, or with major infections.</p>
		                      
		           		<p>The review team was concerned about the &quot;trivialisation&quot; of cosmetic surgery - and took a dim view of reality programmes like The Only Way is Essex (TOWIE).</p>
		                      
		           		<p>It also criticised the promotional deals which some cosmetic providers offer to lure clients.</p>
		                      
		           		<p>Transform says it stopped doing promotions on surgery several years ago, but did have a loyalty points scheme and other discounts for some injectables.</p>
		                      
		           		<p>&quot;That's what patients are asking us to do and that's the norm in the industry - but as a result of the Keogh review we will look again at our marketing and consider what we do in future.</p>
		                      
		           		<p>&quot;We are not trying to entice people to have any kind of cosmetic treatment, and our surgeons turn away nearly 40% of patients because they are unsuitable or because they have unrealistic expectations,&quot; said Pat Dunion.</p>
		                      
		           		<p>I have been a medical guinea pig on several occasions in order to illustrate stories, but I would draw the line at having dermal fillers or any kind of cosmetic treatment - wrinkles and all is the future for me.</p>
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                <link>http://www.bbc.co.uk/news/health-22277890</link>
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                <pubDate>Wed, 24 Apr 2013 10:36:57 +0100</pubDate>
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                <title>Long shadow cast by MMR scare</title>
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		           		<p>It is 15 years since Dr Andrew Wakefield published research suggesting a possible link between the MMR vaccine and autism.</p>
		                      
		           		<p>Although both he and his research have been discredited, the MMR scare still casts a long shadow.</p>
		                      
		           		<p>That may seem improbable, given that MMR coverage rates now exceed the level they achieved before his claims were published in 1998.</p>
		                      
		           		<p>First dose MMR coverage for England now stands at 89% in England and 92.7% in Wales - and latest quarterly figures for both countries suggest rates are edging towards the crucial 95% uptake the World Health Organisation says is needed to provide herd immunity and provide full protection.</p>
		                      
		           		<p>But in 2004 it fell to 80% in England and 78% in Wales. That means more than 100,000 children were not protected in that year alone.</p>
		                      
		           		<p>There is now a huge cohort of children who are not protected and this has allowed the measles virus to circulate - often infecting babies who are too young to have had the MMR vaccine.</p>
		                      
		           		<p>There were 2,016 confirmed cases of measles in England and Wales in 2012, the highest total for 18 years.</p>
		                      
		           		<p>The number of cases in the current Swansea outbreak has reached 620.</p>
		                      
		           		<p>&quot;The age range of those most affected exactly maps the period after the Wakefield scare, so very many are in the 10-14 age group&quot;, said Dr Paul Cosford, medical director, Public Health England.</p>
		                      
		           		<p>Children should get two doses of the MMR vaccine - at around 13 months and a second pre-school booster.</p>
		                      
		           		<p>The first gives about 95% protection against measles, while two doses gives 99-100% protection.</p>
		                      
		           		<p>In Swansea it has taken a huge outbreak of measles to prompt parents to get their children immunised.</p>
		                      
		           		<p>Parents there have been praised by public health officials for bringing their children to special drop-in vaccine clinics.</p>
		                      
		           		<p>But immunisation officials want parents elsewhere to be proactive and not wait until they see an outbreak of measles in their area before getting their children immunised.</p>
		                      
		           		<p>&quot;The message is that it's never too late to get immunised - that means both teenagers and young adults.</p>
		                      
		           		<p>&quot;Parents who are unsure whether their children have had the MMR vaccine can check with their GP,&quot; said Dr Cosford.</p>
		                      
		           		<p>Measles is a highly contagious viral infection. Prior to the introduction of a vaccine it was a major public health threat.</p>
		                      
		           		<p>In 1961 there were 750,000 cases in England and Wales and 152 deaths.</p>
		                      
		           		<p>It causes a distinctive rash on the body - and can lead to meningitis and pneumonia.</p>
		                      
		           		<p>Fortunately there have been no deaths so far in the current outbreak, but around one in five infants infected needs hospital treatment.</p>
		                      
		           		<p>In theory measles could be eradicated - like smallpox it has no animal host. No country in the world has managed to eliminate the disease - although almost all cases in the United States are imported.</p>
		                      
		           		<p>That used to be the situation here for several years until the current surge in cases.</p>
		                      
		           		<p>The outbreak in Wales and others across the UK were the inevitable outcome of years of under-immunisation as this quote from Prof David Salisbury, Director of Immunisation at the 2008 demonstrates.</p>
		                      
		           		<p>&quot;Measles is serious and in some cases it can be fatal. Delaying immunisation puts children at risk.</p>
		                      
		           		<p>&quot;If we continue to accumulate unvaccinated children measles will spread among them - at some point there will be a measles epidemic.</p>
		                      
		           		<p>&quot;The evidence on MMR is absolutely clear - there is no link between the vaccine and autism.&quot;</p>
		                      
		           		<p>What happens in the months and years ahead depends on how parents regard and respond to the current measles threat.</p>
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                <link>http://www.bbc.co.uk/news/health-22085678</link>
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                <pubDate>Tue, 09 Apr 2013 18:46:15 +0100</pubDate>
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                <title>Leeds child heart ops 'had to stop'</title>
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		           		<p>The plan to cut the number of children's heart surgery units in England has led to a bitter and protracted dispute.</p>
		                      
		           		<p>There is almost universal support for the concept of fewer, bigger and better heart units.</p>
		                      
		           		<p>The difficulty has arisen in the choice of units to be axed.</p>
		                      
		           		<p>Like London's Royal Brompton Hospital, Leeds General Infirmary took the &quot;safe and sustainable&quot; reorganisation committee to court, arguing its unit was wrongly identified for closure.</p>
		                      
		           		<p>The release of mortality data at Leeds appalled the head of the group which was still analysing the figures.</p>
		                      
		           		<p>Dr John Gibbs said &quot;it rings of politics rather than proper process&quot;.</p>
		                      
		           		<p>There have even been calls for the resignation of the NHS medical director, Sir Bruce Keogh.</p>
		                      
		           		<p>But Sir Bruce clearly feels he had no choice.</p>
		                      
		           		<p>The final decision on the restructuring of children's heart services may now depend on Health Secretary Jeremy Hunt.</p>
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                <link>http://www.bbc.co.uk/news/health-21974053</link>
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                <pubDate>Fri, 29 Mar 2013 19:24:14 +0000</pubDate>
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                <title>Synchrotron yields 'safer' vaccine</title>
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		        		        	<![CDATA[
		                      
		           		<p>Producing vaccines against viral threats is a potentially hazardous business and that's why manufacturers have to operate strict controls to ensure that no pathogens escape.</p>
		                      
		           		<p>British scientists have developed a new method to create an entirely synthetic vaccine which doesn't rely on using live infectious virus, meaning it is much safer.</p>
		                      
		           		<p>What's more the prototype vaccine they have created, for the animal disease foot-and-mouth, has been engineered to make it more stable.</p>
		                      
		           		<p>That means it can be kept out of the fridge for many hours before returning to the cold chain - overcoming one of the major hurdles in administering vaccines in the developing world.</p>
		                      
		           		<p>The research, published in the journal PLOS pathogens, was a collaboration between scientists at Oxford and Reading Universities, the Pirbright Institute, and the UK's national synchrotron facility, the Diamond Light Source near Oxford.</p>
		                      
		           		<p>Diamond is a particle accelerator which sends electrons round a giant magnetic ring at near light speeds.</p>
		                      
		           		<p>The electrons emit energy in the form of intense X-rays which are channelled along &quot;beamlines&quot; - into laboratories where they are used to analyse structures in extraordinary detail.</p>
		                      
		           		<p>Synchrotrons have been used before to analyse viruses at the atomic level, but the technology has advanced considerably to enable scientists to create a stable synthetic vaccine.</p>
		                      
		           		<p>&quot;What we have achieved here is close to the holy grail of foot-and-mouth vaccines.</p>
		                      
		           		<p>Unlike traditional vaccines, there is no chance that the empty shell vaccine could revert to an infectious form,&quot; said Dave Stuart, Life Sciences Director at Diamond, and MRC Professor of Structural Biology at the University of Oxford.</p>
		                      
		           		<p>&quot;This work will have a broad and enduring impact on vaccine development, and the technology should be transferable to other viruses from the same family, such as poliovirus and hand-foot-and-mouth disease, a human virus which is currently endemic in South-East Asia.&quot;</p>
		                      
		           		<p>These human disease threats, like foot-and-mouth, are all picornaviruses.</p>
		                      
		           		<p>Viruses are inherently unstable and fragile, but picornaviruses can be studied using X-ray crystallography.</p>
		                      
		           		<p>This enables the protein shell of the virus to be analysed at the atomic level - something a billion times smaller than a pinhead.</p>
		                      
		           		<p>As with any vaccine, the aim is to prompt the immune system to recognise this outer shell and destroy the pathogen before it has time to lock onto cells and infect them with its genetic material.</p>
		                      
		           		<p>In this research the scientists created a synthetic viral shell, but lacking its pathogenic RNA interior - the genetic material the virus uses to replicate itself.</p>
		                      
		           		<p>Crucially they were able to reinforce the structure of the viral shell to make it stronger, to improve the stability of the vaccine.</p>
		                      
		           		<p>Pre-clinical trials have shown it to be stable at temperatures up to 56C for at least two hours. Foot-and-mouth is endemic in central Africa, parts of the Middle East and Asia, so this would be a significant improvement over existing vaccines.</p>
		                      
		           		<p>With current foot-and-mouth vaccines it is difficult to distinguish between immunised livestock and those which have been infected.</p>
		                      
		           		<p>That proved to be a major hurdle in controlling the foot-and-mouth outbreak in the UK in 2001 because it would have prevented the export of livestock.</p>
		                      
		           		<p>But the synthetic vaccine should allow scientists to show the absence of infection in vaccinated animals.</p>
		                      
		           		<p>&quot;The foot-and-mouth-disease virus epidemic in the UK in 2001 was disastrous and cost the economy billions of pounds in control measures and compensation,&quot; explained Dr Bryan Charleston, Head of Livestock Viral Diseases Programme at the Pirbright Institute.</p>
		                      
		           		<p>&quot;This important work has been a direct result of the additional funding that was provided as a result of the 2001 outbreak to research this highly contagious disease.&quot;</p>
		                      
		           		<p>The potential hazards of working with viruses was underlined in 2007 when the Pirbright laboratory site was identified as the source of a leak which led to an outbreak of foot-and-mouth disease.</p>
		                      
		           		<p>Polio, another picornavirus, which exclusively affects humans, has been eliminated from nearly every country in the world, although it stubbornly persists in Nigeria, Pakistan and Afghanistan.</p>
		                      
		           		<p>The need for secure vaccine production will become even more vital should polio be wiped out.</p>
		                      
		           		<p>&quot;Current polio vaccines, which use live virus for their production, pose a potential threat to the long-term success of eradication if they were to re-establish themselves in the population.</p>
		                      
		           		<p>&quot;Non-infectious vaccines would clearly provide a safeguard against this risk&quot;, said Dr Andrew Macadam, a virologist specialising in polio at the National Institute for Biological Standards and Control in Hertfordshire.</p>
		                      
		           		<p>&quot;This technology has great potential in terms of cost and biosafety.</p>
		                      
		           		<p>&quot;Any design strategy that minimises the chances of accidental virus release would not only make the world a safer place but would lower the bio-containment barriers to production allowing vaccines to be made more cheaply all over the world.&quot;</p>
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                <link>http://www.bbc.co.uk/news/health-21958361</link>
                <guid isPermaLink="true">http://www.bbc.co.uk/news/health-21958361</guid>
                <pubDate>Wed, 27 Mar 2013 22:00:04 +0000</pubDate>
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                <title>'Warmed liver' transplant first</title>
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		           		<p>Surgeons in London have carried out the first 'warm liver' transplant using an organ which was 'kept alive' at body temperature in a machine.</p>
		                      
		           		<p>Usually donor livers are kept on ice, but many become damaged as a result.</p>
		                      
		           		<p>The patient, 62-year-old Ian Christie from Devon, is doing well after the operation at King's College Hospital.</p>
		                      
		           		<p>The technology was developed by scientists at Oxford University who hope it could increase the number of livers available for transplant.</p>
		                      
		           		<p>Its inventors are an engineer and a transplant surgeon.</p>
		                      
		           		<p>Prof Constantin Coussios of the Department of Engineering Science has been working on the project for 15 years in partnership with Prof Peter Friend, of the Nuffield Department of Surgical Sciences.</p>
		                      
		           		<p>After being removed from the donor, the liver is placed in the machine and tubes are connected to the main blood vessels. Oxygenated blood and nutrients are pumped through the liver which continues to function and produce bile.</p>
		                      
		           		<p>Prof Peter Friend said: &quot;It provides an environment where the donor liver hardly knows it has left the body. Instead of cooling it to slow its metabolism we keep it functioning at normal temperature and with oxygen and nutrition.&quot;</p>
		                      
		           		<p>At present many donor livers are rejected for transplantation because they are damaged. Some have been deprived of oxygen while others contain too much fat and do not survive the cooling process.</p>
		                      
		           		<p>The Oxford inventors say their machine allows the liver to recover from damage it has sustained and enables medical staff to test the viability of the organ to see whether it is likely to work before being transplanted into the patient.</p>
		                      
		           		<p>Ian Christie, the first patient to receive a liver using the new technique contracted hepatitis C from a blood transfusion 25 years ago, before blood could be screened for the infection. He developed liver cirrhosis and was told last year that without a transplant he might have about 18 months to live.</p>
		                      
		           		<p>Mr Christie, who had the surgery last month, said: &quot;I feel very proud and lucky to have been part of this medical advance. My health is better than it's been for years and I feel I can go on now instead of thinking that life is finished for me.&quot;</p>
		                      
		           		<p>A second patient who received a liver using the same technique is also said to be doing well.</p>
		                      
		           		<p>The livers given to Mr Christie and the other patient were preserved for five and nine hours respectively, but the Oxford team believes its system could allow donor livers to be maintained for much longer.</p>
		                      
		           		<p>About 700 liver transplants are carried out in the UK each year, but more than 100 patients a year die while on the waiting list.</p>
		                      
		           		<p>Prof Coussios said: &quot;In experiments we have shown we can preserve a liver and monitor its function outside the body for periods up to 24 hours. By contrast livers kept on ice have to be transplanted with 10-12 hours at most.&quot;</p>
		                      
		           		<p>If livers could be preserved for longer it would allow teams to organise transplant surgery more effectively and to find the ideal recipient.</p>
		                      
		           		<p>King's College Hospital performs more than 200 liver transplants each year making it the largest unit in Europe.</p>
		                      
		           		<p>Wayel Jassem, transplant surgeon who performed both operations, said: &quot;I was impressed to see how quickly each liver started to function following the transplant. This technology has the potential to be hugely significant and could save lives.&quot;</p>
		                      
		           		<p>But the inventors in Oxford and the transplant team in London stress it is too early to draw any firm conclusions as to the benefits of 'warm liver' transplantation. A further eight patients will receive livers using the new technique at King's College Hospital.</p>
		                      
		           		<p>Following this initial safety trial a broader study across three European countries is planned. It may be several years before liver specialists can tell whether the technique has proven benefits.</p>
		                      
		           		<p>Five years ago Oxford University set up a spin-out company, OrganOx, to commercialise the technology. It has financial support from the Royal Society and a venture capital fund. The company hopes its device will get European approval via a CE mark later this year.</p>
		                      
		           		<p>The concept of keeping donor organs at body temperature and preserving their function is also being tested in heart and lung transplants.</p>
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		        </description>
                <link>http://www.bbc.co.uk/news/health-21788533</link>
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                <pubDate>Fri, 15 Mar 2013 17:06:21 +0000</pubDate>
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                <title>The man who gives away £600m a year</title>
                <description>    
                               
		        		        	<![CDATA[
		                      
		           		<p>Imagine having £600m to give away - every year. That is what Sir Mark Walport has been doing for the past decade at the Wellcome Trust.</p>
		                      
		           		<p>It is the biggest medical charity in Europe and second in the world to the Gates Foundation in terms of grants.</p>
		                      
		           		<p>Since he became director in 2003 the trust has spent £5.6bn on medical research, education and promoting the public understanding of science.</p>
		                      
		           		<p>&quot;Our policy is to support the brightest minds - smart people at every stage of their careers - as well as recognising the value of teams. The role of the trust is catalytic - to enable people to achieve advances for human and animal health that might not otherwise happen.&quot;</p>
		                      
		           		<p>At the end of the month Sir Mark is leaving to become the government's chief scientific adviser.</p>
		                      
		           		<p>I met him in his glass office overlooking the Euston underpass in London and asked him to reflect on the past decade.</p>
		                      
		           		<p>No doubt what he sees as the dominant scientific advance of the decade - human genetics.</p>
		                      
		           		<p>It was 10 years ago that scientists announced they had completed sequencing the human genome.</p>
		                      
		           		<p>It took 13 years and cost a fortune. Now the Wellcome Trust Sanger Institute - which consumes 15% of the charity's budget - can do multiple genomes each day. The prospect of a £1,000 genome seems not too distant.</p>
		                      
		           		<p>So what good has decoding our DNA done for human health? A revolution in the understanding of human disease was promised, with the prospect of more personalised medicines.</p>
		                      
		           		<p>&quot;People said it was hyped, but if anything the benefits of the project were underestimated,&quot; says Sir Mark.</p>
		                      
		           		<p>&quot;It was a decade ago that the BRAF gene was shown, by scientists at the Wellcome Trust Sanger Institute, to be mutated in many patients with the skin cancer malignant melanoma.</p>
		                      
		           		<p>&quot;In 2011 vemurafenib was approved - a drug that works solely in patients that carry that mutated gene. That was a direct result of the human genome project.&quot;</p>
		                      
		           		<p>Sir Mark says genome science has also led to improvements in the diagnosis and categorisation of inherited diseases and treatments for inherited forms of diabetes, based on a patient's genetic makeup.</p>
		                      
		           		<p>Microbial genetics is enabling a more precise definition of bacterial, viral and parasitic threats - and how they develop resistance to treatments. DNA sequencing is also enabling disease threats to be tracked as they spread round the world.</p>
		                      
		           		<p>&quot;Medical genomics is the technology of the present not the future. Last year we used DNA sequencing to help bring an outbreak of MRSA at Addenbrooke's hospital in Cambridge to a halt.</p>
		                      
		           		<p>&quot;It enabled us to track down the staff member who was carrying MRSA, treat them and remove the risk to patients.&quot;</p>
		                      
		           		<p>The Wellcome Collection is a museum on the Euston Road, next door to the trust.</p>
		                      
		           		<p>It has been an unexpected hit since opening to the public in 2007, with more than two million visitors. Described as a &quot;free destination for the incurably curious&quot; it has hosted exhibitions on topics as diverse as death, sleep, dirt and miracles.</p>
		                      
		           		<p>It also houses the permanent collection of Sir Henry Wellcome, the founder of the trust, who made a fortune in pharmaceuticals.</p>
		                      
		           		<p>Sir Henry had a wide and varied interest in health, the human body and artefacts linked to the famous. From Napoleon's toothbrush to George III's hair, Florence Nightingale's moccasins and an iron and velvet chastity belt - it is well worth a visit.</p>
		                      
		           		<p>His role will change from chief executive to purely advisory. &quot;It's bound to be frustrating,&quot; he says.</p>
		                      
		           		<p>&quot;But it's an important job - the interplay between science and the economy is of paramount importance. There will be challenges and opportunities as well as frustrations.&quot;</p>
		                      
		           		<p>Sir Mark says the security of our energy supply - making sure the lights don't go out and that our infrastructure works - are the obvious challenges ahead. But it is unexpected emergencies which may consume his time.</p>
		                      
		           		<p>The man he is replacing - Sir John Beddington - had to provide advice on Japan's Fukushima nuclear accident, Iceland's volcanic ash eruption and the spread of Ash dieback. It's clear then that future threats could come from any quarter.</p>
		                      
		           		<p>Perhaps a memento from his time at Wellcome might inspire him in difficult times ahead.</p>
		                      
		           		<p>So what exhibit would Sir Mark like to slip into the cardboard packing cases already accumulating outside the door of his office?</p>
		                      
		           		<p>&quot;Charles Darwin's cane,&quot; he says. The walking-stick has a whalebone and ivory top decorated with a carving of a human skull.</p>
		                      
		           		<p>&quot;I'd like to have that, but I doubt the museum will let me walk off with it.&quot;</p>
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		        </description>
                <link>http://www.bbc.co.uk/news/health-21771504</link>
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                <pubDate>Wed, 13 Mar 2013 13:30:20 +0000</pubDate>
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                <title>Why do the Italians live longer than us?</title>
                <description>    
                               
		        		        	<![CDATA[
		                      
		           		<p>What is it about the Italians? They smoke more than us, they earn less, their economy is in even worse shape than ours, they spend less on healthcare, and yet - they live longer. Not just a bit, but a whopping 18 months more on average.</p>
		                      
		           		<p>They also have more years of good health before disease and disability set in.</p>
		                      
		           		<p>The UK did poorly in a comparison of health outcomes in 19 countries over 20 years published in the Lancet.</p>
		                      
		           		<p>On life expectancy we came 14th - slipping down two places since 1990. Italy, by contrast, rose from 5th to 2nd - ahead of France, Germany, and Sweden.</p>
		                      
		           		<p>This is all the more astonishing given that, until the 1970s, Britons lived longer than Italians.</p>
		                      
		           		<p>So how did La Dolce Vita overtake the British Good Life?</p>
		                      
		           		<p>Part of it is down to dramatic improvements in living standards in Italy from the 1960s - the shift from crushing poverty to growing affluence.</p>
		                      
		           		<p>There have been improvements in living standards here of course. But Alan Maryon-Davis, honorary Professor of Public Health at King's College London suggests that Italy is a more cohesive and less divided society than ours. He said &quot;There is a flatter social gradient - less difference between the haves and have-nots in Italy, and that is likely to play a role in health outcomes.&quot;</p>
		                      
		           		<p>He also speculated whether the British psyche was fatalistic when it came to illness: &quot;I wonder if many people feel that they can ignore their health for decades in the expectation that the NHS will be there to bail them out when they get into trouble.&quot;</p>
		                      
		           		<p>In the 1970s a universal National Health Service was established in Italy which was modelled in part on the NHS. Successive Italian governments poured money into health - for decades Italy spent significantly more on its health service than Britain. Only recently has UK spending caught up and overtaken that of Italy.</p>
		                      
		           		<p>It's true that Italians are more likely to smoke than Britons - 23% of adults there compared to 20% here. But until around 2006 Italy had fewer smokers; our levels have simply fallen faster than theirs, meaning adults here are still paying the price of decades of greater cigarette consumption.</p>
		                      
		           		<p>The Mediterranean diet is also likely to be a factor in Italian longevity. Stefania Salmaso, Director, National Centre for Epidemiology and Health Promotion in Rome, told me: &quot;Since the 1960s there has been a big improvement in the Italian diet, with much more fresh fish and a wider variety of foods. Fresh vegetables and fruit are commonly available and we use a lot of olive oil in cooking, and less animal fats than is found in British dishes.&quot;</p>
		                      
		           		<p>Traditionally, Italians have drunk wine with meals and avoided the sort of binge drinking that is commonplace in Britain, but Dr Salmaso warns that habits are changing for the worse among the young.</p>
		                      
		           		<p>Several studies have linked the Mediterranean diet with a reduced risk of heart disease. Only last month a trial in the New England Journal of Medicine involving more than 7,000 people in Spain found that those given either a litre of extra virgin olive oil, or 200g of walnuts, hazelnuts and almonds every week for five years had a significantly reduced risk of stroke and heart disease compared to a third control group who were simply advised to have a low-fat diet.</p>
		                      
		           		<p>How do the Italians view their health? Do they celebrate their position as among the longest living nations in the world? Apparently not. &quot;Not a single Italian journalist contacted me about the Lancet study&quot; said Stefania Salmaso in Rome. &quot;People here don't realise how lucky they are. All the focus is on the political crisis. I think that good news gets ignored.&quot;</p>
		                      
		           		<p>Can we be certain why average life expectancy in Italy is 81.5 years compared to 79.9 in the UK? Is it diet, healthcare, social structure, even climate - and which is the most important? Dr Edmund Jessop, vice-president, UK Faculty of Public Health, told me: &quot;To be honest, nobody knows. Life expectancy looks like a simple number but it's incredibly complicated - with a huge number of factors all playing a part. We can speculate about the causes, but it's impossible to give a single definitive answer.&quot;</p>
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		        </description>
                <link>http://www.bbc.co.uk/news/health-21690003</link>
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                <pubDate>Thu, 07 Mar 2013 02:44:29 +0000</pubDate>
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                <title>Roche trial data pledge</title>
                <description>    
                               
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		           		<p>The pharmaceutical company Roche has announced that it will make more of the data from its clinical trials available to researchers.</p>
		                      
		           		<p>The company says it will appoint a panel of experts to evaluate and approve requests to access anonymised patient data.</p>
		                      
		           		<p>But the announcement has been dismissed as &quot;pathetic&quot; by campaigners arguing for greater transparency from the pharmaceutical industry - an issue I wrote about last month.</p>
		                      
		           		<p>It's estimated that half of all clinical trials have never been published and positive trial results are twice as likely to be published as negative findings. The AllTrials campaign wants the pharmaceutical industry to publish all data, and is supported by the Wellcome Trust, the BMJ and NICE.</p>
		                      
		           		<p>Roche, which makes the anti-viral medicine Tamiflu, has been repeatedly criticised by researchers for failing to grant access to all its data on the drug.</p>
		                      
		           		<p>In response Roche has appointed a four man panel headed by flu expert Prof Albert Osterhaus to look at data on Tamiflu which the company says will &quot;identify unanswered questions&quot;.</p>
		                      
		           		<p>Roche says it will also appoint an &quot;independent body&quot; to assess the validity of requests for unpublished trial data for its other medicines.</p>
		                      
		           		<p>Daniel O'Day, Chief Operating Officer of Roche Pharma said: &quot;We understand and support calls for our industry to be more transparent about clinical trial data with the aim of meeting the best interests of patients and medicine.&quot;</p>
		                      
		           		<p>Mr O'Day told me that although the company would appoint the experts, the panel would be independent and would &quot;stand up to public scrutiny&quot;.</p>
		                      
		           		<p>But the announcement has been met with derision by the organisation Sense About Science, which helped initiate the AllTrials campaign for all clinical research to be published. Its director Tracey Brown said: &quot;Does Roche expect applause for announcing that it will continue to keep clinical trial findings hidden? They're on another planet. Roche's response is pathetic. Which bit of All and Trials do they not understand?&quot;</p>
		                      
		           		<p>Carl Heneghan, Director, Centre of Evidence-Based Medicine, University of Oxford, who is part of the Cochrane team reviewing Tamiflu said, &quot;How can any panel be independent if they appoint it and oversee it? It also means there will be confidentiality clauses within any agreement. Either you provide the data in a transparent manner or you don't.&quot;</p>
		                      
		           		<p>Earlier this month GSK became the first major pharmaceutical company to pledge its support for the AllTrials campaign. GSK said it would publish all clinical trial data dating back to the formation of the company in 2000 when it merged with SmithKline Beecham.</p>
		                      
		           		<p>In the past GSK has been caught withholding safety data and last year it agreed to pay $3bn (£1.9bn) in the largest healthcare fraud settlement in US history after promoting two drugs for unapproved uses and other failures.</p>
		                      
		           		<p>Its support for the AllTrials campaign is seen as highly significant.</p>
		                      
		           		<p>Dr Heneghan said that GSK had provided him with all 30 clinical study reports (CSR) - regarding its anti-viral flu drug Relenza whereas he had received just one regarding Roche's drug Tamiflu.</p>
		                      
		           		<p>Roche says it has published 71 out of 74 Tamiflu trial results but these can be just short summaries and not the raw data of clinical study reports which can run into hundreds of pages.</p>
		                      
		           		<p>The doctor and columnist Ben Goldacre, who has spearheaded the campaign for data transparency said GSK had &quot;led the field&quot; by signing up to AllTrials and it was &quot;bizarre to see that Roche expect to be praised today for continuing to withhold data.&quot; He predicted that the era of drug companies and researchers &quot;routinely withholding important information about clinical trials is coming to an end.&quot;</p>
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                <link>http://www.bbc.co.uk/news/health-21595895</link>
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                <pubDate>Tue, 26 Feb 2013 18:00:06 +0000</pubDate>
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                <title>Horsemeat - food fraud, not food safety</title>
                <description>    
                               
		        		        	<![CDATA[
		                      
		           		<p>You may have noticed that I've spent quite a bit of my time reporting about horsemeat in recent days.</p>
		                      
		           		<p>I'm the medical correspondent and so that might make you assume that there is a strong health angle to the horsemeat contamination scandal.</p>
		                      
		           		<p>The evidence so far would suggest otherwise. This is a food fraud rather than a food safety issue.</p>
		                      
		           		<p>Unlike most of the health stories I cover, no one has got ill or is likely to get ill as a result of the horsemeat contamination.</p>
		                      
		           		<p>What about the equine painkiller bute? The Food Standards Agency says horse carcasses with traces of the anti-inflammatory have been exported and have been entering the food chain for some time.</p>
		                      
		           		<p>This is clearly one of the many failures exposed by this affair.</p>
		                      
		           		<p>Bute - or phenylbutazone - is licensed in humans to treat ankylosing spondylitis - a severe form of arthritis that affects the back.</p>
		                      
		           		<p>In long-term use it carries a one in 30,000 risk of a serious side effect - the bone marrow disorder aplastic anaemia. It is no longer commonly prescribed and there hasn't been a case of this linked to the drug since at least 1985.</p>
		                      
		           		<p>In order to get a single therapeutic dose of bute from horsemeat you'd need to eat 500-600 250g horse burgers. That's an awful lot of meat.</p>
		                      
		           		<p>Of course there may be other drugs such as traces of antibiotics which might be found in unregulated horsemeat that enters the food chain.</p>
		                      
		           		<p>The Chief Medical Officer, Prof Sally Davies, said the levels would be so low as not to represent a health risk, although she is deeply worried about the long-term threat of antibiotic resistance in the human and animal world. That is another issue.</p>
		                      
		           		<p>If horsemeat was used which was rancid or infected that would present other potential health concerns but no-one has found evidence of this. Properly cooked meat would get rid of most pathogens.</p>
		                      
		           		<p>There is of course what Prof Davies called the yuck factor. We all like to know what we are eating, and that we can trust the labels on our food.</p>
		                      
		           		<p>Horsemeat is popular in mainland Europe, in countries like Italy, France and Belgium. It is a lean meat and I'm told used to be widely used overseas to build the strength of patients who were convalescing.</p>
		                      
		           		<p>But for cultural reasons horsemeat is not popular in Britain and the current food scandal is unlikely to change that.</p>
		                      
		           		<p>The results of tests which companies were ordered to carry out revealed that the vast majority of processed beef products are free of horsemeat.</p>
		                      
		           		<p>But how many of us have unwittingly eaten horsemeat, and how long has the mislabelling of products been going on?</p>
		                      
		           		<p>The chief executive of the Food Standards Agency, Catherine Brown, was candid: &quot;These tests are a snapshot so we will never know the full extent - it is shocking.&quot;</p>
		                      
		           		<p>The food industry still has to rebuild public confidence so that consumers feel they can trust the labels on supermarket shelves.</p>
		                      
		           		<p>There is one definite health risk associated with the horsemeat affair. Eating processed meat products carry an increased long-term risk of cancer. If the horsemeat scandal encourages people to eat fewer meals of mass-produced burgers, lasagne and bolognese, it would be one positive outcome from this unpleasant scandal.</p>
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                <link>http://www.bbc.co.uk/news/health-21482127</link>
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                <pubDate>Fri, 15 Feb 2013 23:16:02 +0000</pubDate>
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                <title>Sars-like virus 'spreads in people'</title>
                <description>    
                               
		        		        	<![CDATA[
		                      
		           		<p>The emergence of any new virus that poses a threat to human health is a cause for concern.</p>
		                      
		           		<p>If the pathogen can spread from person to person, it becomes a significant issue. But the indications are the dangers to the general population are very low.</p>
		                      
		           		<p>The very small number of cases strongly suggests if it does pass between people, it is not very contagious.</p>
		                      
		           		<p>It appears infected animals - possibly bats - are the source of most of the cases so far.</p>
		                      
		           		<p>Coronaviruses cannot survive outside the body for more than 24 hours and are killed by most detergents.</p>
		                      
		           		<p>You will see it described as a &quot;Sars-like virus&quot; in headlines. But a key difference is that it does not pass easily from person to person.</p>
		                      
		           		<p>Furthermore, it is also from the same family of viruses that produce the common cold.</p>
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		        </description>
                <link>http://www.bbc.co.uk/news/health-21442519</link>
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                <pubDate>Wed, 13 Feb 2013 13:23:15 +0000</pubDate>
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                <title>Tuberculosis vaccine hopes dashed</title>
                <description>    
                               
		        		        	<![CDATA[
		                      
		           		<p>A major trial of a new booster vaccine has ended in failure, marking a major setback in the fight against tuberculosis (TB).</p>
		                      
		           		<p>It was the first big study in infants since the Bacillus Calmette-Guerin (BCG) vaccine was introduced in 1921.</p>
		                      
		           		<p>BCG is only partially effective against the bacterium that causes TB, which is why several international teams are working on new vaccines.</p>
		                      
		           		<p>The latest, known as MVA85A, failed to protect babies who had already had BCG.</p>
		                      
		           		<p>The trial, in South Africa, involved 2,794 healthy children aged four to six months, half of whom received MVA85A and the rest a placebo.</p>
		                      
		           		<p>They were followed up for an average of two years.</p>
		                      
		           		<p>The researchers, reporting in the Lancet medical journal, found 32 cases of TB in those who had received the vaccine compared with 39 in the placebo group.</p>
		                      
		           		<p>This gave an effectiveness of 17%, which is so low as to be statistically non-significant.</p>
		                      
		           		<p>Designed to boost the immune responses that have been primed by the BCG vaccine, MVA85A has been undergoing human trials for more than a decade, showing it to be safe and to stimulate a high level of immune response in adults.</p>
		                      
		           		<p>Prof Helen McShane, from the University of Oxford, who developed the vaccine, said: &quot;[It] induced modest immune responses against TB in the infants, but these were much lower than those previously seen in adults, and were insufficient to protect against the disease.</p>
		                      
		           		<p>&quot;This is the first efficacy trial of a new TB vaccine since Bacille Calmette-Guérin, a significant step in itself, and there is much that we and others can learn from the study and the data it has produced.&quot;</p>
		                      
		           		<p>In an accompanying editorial Christopher Dye, of the World Health Organization (WHO), and Paul Fine, from the London School of Hygiene and Tropical Medicine, said although the results were disappointing they were &quot;not a terminal prognosis for MVA85A, or for any of the other tuberculosis vaccines in development&quot;.</p>
		                      
		           		<p>They added: &quot;Now is a key moment in tuberculosis vaccine research.</p>
		                      
		           		<p>&quot;If the history of tuberculosis vaccine research teaches us anything, it is to expect surprises. We need to go on playing the high-stakes game.&quot;</p>
		                      
		           		<p>The MVA85A study was funded by AERAS, the Wellcome Trust and Oxford-Emergent Tuberculosis Consortium.</p>
		                      
		           		<p>AERAS, a not-for-profit organisation, was set up to develop new TB vaccines. MVA85A was the most advanced of six vaccine candidates it is helping develop.</p>
		                      
		           		<p>Dr Tom Evans, interim CEO of AERAS said: &quot;Because of the urgency to control the global TB epidemic, and despite these trial results, we remain steadfast in our belief that an improved TB vaccine will be developed and represents the best hope for eliminating the disease.&quot;</p>
		                      
		           		<p>TB is a major global health problem with an estimated 8.7 million cases and 1.4 million deaths a year, according to the WHO.</p>
		                      
		           		<p>The disease is the leading cause of death among people with HIV in South Africa.</p>
		                      
		           		<p>Dr Richard White, an epidemiologist at the London School of Hygiene &amp; Tropical Medicine and Director of the TB Modelling and Analysis Consortium, said:</p>
		                      
		           		<p>&quot;This is a very disappointing result, but this was just the first of around 12 new tuberculosis vaccines currently being tested in humans and around 50 vaccine candidates currently being tested in the lab. It was a historic trial, the first of a new TB vaccine for nearly a century. It will lead to much valuable knowledge to help us design effective vaccines in the future. &quot;</p>
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                <link>http://www.bbc.co.uk/news/health-21302518</link>
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                <pubDate>Mon, 04 Feb 2013 12:18:01 +0000</pubDate>
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                <title>Bill Gates: The world can defeat polio</title>
                <description>    
                               
		        		        	<![CDATA[
		                      
		           		<p>Glance at the latest figures for polio incidence and it would appear that the world is within touching distance of eradicating the disease.</p>
		                      
		           		<p>Last year there were just 205 cases of naturally occurring poliovirus compared with 650 cases in 2011 and a staggering 350,000 a quarter of a century ago.</p>
		                      
		           		<p>There are now three countries - Pakistan, Afghanistan and Nigeria - where transmission of the disease has never been halted compared to 125 countries in the late 1980s.</p>
		                      
		           		<p>India has been polio-free for two years - a remarkable achievement.</p>
		                      
		           		<p>This week the billionaire philanthropist Bill Gates will deliver the annual BBC Richard Dimbleby Lecture in which he will spell out his commitment to ridding the world of this dread infectious disease which can cause paralysis and even death within hours.</p>
		                      
		           		<p>Bill Gates is the single most influential voice in global health, so when he turns his attention to an issue, it is worth listening.</p>
		                      
		           		<p>Through the Gates Foundation, Bill and his wife Melinda have already given away nearly $30 billion of their fortune and there are tens of billions more in the pipeline.</p>
		                      
		           		<p>He has spoken to me previously of his passionate belief in the power of vaccines and his determination to defeat polio.</p>
		                      
		           		<p>In his lecture Mr Gates will liken the pace of innovation in computers with the fight against polio: .</p>
		                      
		           		<p>He will say: &quot;In the late 1970s we had a dream of giving everybody access to computer technology - a vision of a computer on every desktop. Now there is a computer in every pocket.</p>
		                      
		           		<p>&quot;The pace of innovation keeps getting faster. The same is true of polio.</p>
		                      
		           		<p>&quot;It was first recognised at least 4,000 years ago, but it was just 200 years ago we figured out it's contagious - just 100 years ago we learned it's a virus. Just 50 years ago we developed the vaccine to prevent it.</p>
		                      
		           		<p>&quot;Just 25 years ago we resolved to eradicate it. And so on.&quot;</p>
		                      
		           		<p>But Mr Gates will also acknowledge that the final push against polio is proving extremely difficult: &quot;I can say without reservation that the last mile is not only the hardest mile; it's also much harder than I expected,&quot; he said.</p>
		                      
		           		<p>The killing of nine health workers in Pakistan last month was a shocking reminder of the challenges facing those trying to chase down the virus and protect every last child. I have written before of the hurdles facing immunisation teams.</p>
		                      
		           		<p>Part of polio's danger is its utter portability - it can be spread across borders by one infected traveller, who can continue to shed virus for weeks on end.</p>
		                      
		           		<p>Only last week an emergency vaccination programme was ordered in Cairo after samples of the polio virus were found in sewage - the strain matches that in southern Pakistan.</p>
		                      
		           		<p>The oral polio vaccine can - in very rare cases - trigger polio. The WHO says this happens in one in 2.5 million first doses of vaccine.</p>
		                      
		           		<p>Over the past decade 15 billion doses of polio vaccine drops have been given and there have been 200 confirmed cases of circulating vaccine-derived polio virus.</p>
		                      
		           		<p>But with naturally occurring polio cases now so low there is a minority which claims the oral live vaccine is causing significant harm.</p>
		                      
		           		<p>Dr Jacob Puliyel, a paediatrician in Delhi, wrote in the Indian Journal of Medical Ethics last year that &quot;the polio eradication programme epitomises nearly everything that is wrong with donor-funded 'disease specific' vertical projects, at the cost of investments in community-oriented primary care&quot;.</p>
		                      
		           		<p>Dr Puliyel said the money spent on fighting polio in India would have been put to better use on water, sanitation and routine immunisation.</p>
		                      
		           		<p>Dr Puliyel blames the polio vaccine for a sharp rise in India of cases of Acute Flaccid Paralysis - weakness or inability to move limbs.</p>
		                      
		           		<p>But polio is just one of many causes, with other viruses and bacteria also responsible. Public health officials also point out that monitoring of cases is now far better than in previous decades.</p>
		                      
		           		<p>In pure economic terms it is hard to justify the $1bn (£630m) spent annually on driving down polio cases by a few hundred each year.</p>
		                      
		           		<p>It makes sense only if global eradication is achieved. Then the repeated - sometimes monthly - polio immunisation rounds in at-risk communities can stop and the vaccine be part of the standard childhood schedule.</p>
		                      
		           		<p>This is a now or never moment - kick polio off the planet over the next few years or face a humiliating retreat which could see the virus re-emerge in scores of countries.</p>
		                      
		           		<p>Bill Gates recognises what is at stake for global health: &quot;Polio eradication is a proving ground, a test. It will reveal what human beings are capable of, and suggest how ambitious we can be about our future.&quot;</p>
		                      
		           		<p>The 2013 Richard Dimbleby Lecture will be shown on Tuesday 29 January on BBC One at 22:35 GMT</p>
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                <link>http://www.bbc.co.uk/news/health-21207601</link>
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                <pubDate>Mon, 28 Jan 2013 01:14:09 +0000</pubDate>
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                <title>Trust of medical volunteers 'betrayed'</title>
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		           		<p>If you signed up to a medical trial you might assume that the results of the research would eventually be published. But that is far from certain. Pharmaceutical companies are under no legal obligation to publish all the available data about drugs.</p>
		                      
		           		<p>A group of 53 clinical trial participants has written an open letter to the European Medicines Agency - the body which licenses drugs. Some of the individuals are healthy volunteers and other have conditions like cancer.</p>
		                      
		           		<p>They say that many participants in trials have been misled because thousands of clinical trials have not been published. They point out that important data from trials may not be available to doctors, researchers or regulators who work on particular diseases.</p>
		                      
		           		<p>The letter is part of a growing campaign to force the industry to be more open and has support from the British Medical Journal and Sense About Science.</p>
		                      
		           		<p>Ben Goldacre, doctor and Bad Science columnist in the Guardian been a driving force behind this issue. Author of 'Bad Pharma' he said: &quot;This is medicine's dirty secret, so it's great to see patients speaking out, and so many eminent organisations joining up, to finally fix this problem.</p>
		                      
		           		<p>A petition calling for all results to be registered has so far attracted 8,000 signatures. Among those who have signed are the Cochrane Collaboration - which analyses clinical data, and the Medical Research Council, which now makes publication a condition of all studies it funds.</p>
		                      
		           		<p>Just what proportion of trials are kept under wraps is unclear - one of Donald Rumsfeld's known unknowns - but a 2010 study from the National Institute of Health Research suggests that half are never published, and those with positive results twice as likely to get into print.</p>
		                      
		           		<p>Earlier this week the Commons Health Select Committee said drug companies should be legally obliged to share data so that they cannot deliberately withhold adverse results.</p>
		                      
		           		<p>Carl Heneghan, Director, Centre of Evidence-Based Medicine, University of Oxford is part of a Cochrane team reviewing the effectiveness of the anti-viral drugs Tamiflu and Relenza. The government spent £500 m stockpiling Tamiflu for use in the H1N1 influenza pandemic.</p>
		                      
		           		<p>The review is clearly important if policymakers and governments are to decide whether the money spent on anti-virals was worth it and whether they should do so again in the event of another pandemic.</p>
		                      
		           		<p>He told me that he was 'getting nowhere' with Roche, makers of Tamiflu who had refused to hand over much of its clinical trial data. For its part Roche cites issues of patient confidentiality and says it disputes the methods being used by Cochrane.</p>
		                      
		           		<p>Dr Heneghan has also spent 'four to five months' negotiating access to data from GSK, makers of Relenza but has yet to receive the clinical study reports. GSK told me it was committed to release the material provided - again the issue of patient confidentiality was raised. Last year GSK said it was committed to provide researchers with the detailed data that underpin its trial results.</p>
		                      
		           		<p>I have taken part in a number of trials including one of an avian flu vaccine at Oxford University. I did receive a detailed summary of trial results.</p>
		                      
		           		<p>Prof Andrew Pollard, Director of the Oxford Vaccine Group said it was a condition of all contracts with industry that the results would be released and editorial control rested with the researchers.</p>
		                      
		           		<p>From January 2014 the European Medicines Agency will publish all clinical study reports - the data behind medical trials, which often run into hundreds of pages. This is already done in the US by the Food and Drug Administration.</p>
		                      
		           		<p>But that still leaves all the trial data which is never submitted to the regulators.</p>
		                      
		           		<p>This issue makes the pharma industry an easy target for critics and it seems surprising that bona fide researchers are still encountering resistance.</p>
		                      
		           		<p>The Association of the British Pharmaceutical Industry (ABPI) says increasing amounts of data are being published but there must be recognition that 'release of commercially confidential information could undermine investment in research and development of future medicines'.</p>
		                      
		           		<p>Doctors and patients will not want to damage the millions that are spent by drug companies developing new medicines. Equally, drugs firms that demonstrate they have nothing to hide by giving full access to data could receive a massive boost in support from patients, medical staff and those all-important trial volunteers.</p>
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                <link>http://www.bbc.co.uk/news/health-21066261</link>
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                <pubDate>Fri, 18 Jan 2013 03:20:14 +0000</pubDate>
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                <title>Could we ever run out of blood?</title>
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		           		<p>Urgent appeals for blood donors seem to be a regular event - certainly at this time of year. So what triggers an appeal and is it feasible that we could ever run out of blood?</p>
		                      
		           		<p>NHS Blood and Transplant (NHSBT), which runs the service in England and north Wales, put out an urgent appeal for O negative donors last week. It currently has just 3.2 days of O neg blood, while the Welsh Blood Service has four days and the Scottish Blood Transfusion Service has 6.1 days.</p>
		                      
		           		<p>People who are O neg are so-called &quot;universal donors&quot; as their blood can be given to patients will different blood groups.</p>
		                      
		           		<p>Blood donations are used for a wide range of conditions including anaemia, leukaemia, during surgery and following organ transplant.</p>
		                      
		           		<p>The last urgent appeal was in the run-up to the Olympics, when there were concerns that the national focus on a summer of sporting events combined with a large influx of visitors, might mean a shortage of blood.</p>
		                      
		           		<p>The appeal was a success with O neg stocks reaching seven days, and other targets for donation being met.</p>
		                      
		           		<p>Jon Latham, from NHSBT, says very careful consideration is given before making an urgent appeal for donors: &quot;As soon as we make an appeal, donors respond, but we have to be careful not to do them too often. That's why I have absolute confidence that we would never run out of blood.&quot;</p>
		                      
		           		<p>Every year 225,000 new donors are needed just to replace those who drop off the register. So while urgent appeals are there to deal with sudden dips in donation, there is a constant quest to recruit volunteers.</p>
		                      
		           		<p>One worrying trend is the 20% drop in the number of young people giving blood over the past decade. Last year there was a 50% drop in 17-18 years olds registering compared to 2011.</p>
		                      
		           		<p>Jon Latham says the Olympics seemed to have a &quot;distracting effect&quot; on donors aged 17-18 with a marked decline during and after the Games.</p>
		                      
		           		<p>Mr Latham said a number of new approaches were being tried to appeal to younger donors: &quot;We do a lot with social media and now have a smartphone app which allows people to search for donor sessions.&quot;</p>
		                      
		           		<p>Two months ago NHSBT launched an appeal for 100,000 new donors in 100 days, with young actors from the Hollyoaks television soap fronting the campaign.</p>
		                      
		           		<p>A major innovation in 2013 will be the launch of an online portal which, for the first time, will allow donors to book and change appointments and access personalised information. NHSBT hope this self-service approach will appeal particularly to younger donors.</p>
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                <link>http://www.bbc.co.uk/news/health-20946568</link>
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                <pubDate>Tue, 08 Jan 2013 15:20:28 +0000</pubDate>
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                <title>Top ten Christmas health risks</title>
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		           		<p>Ready for Christmas? You may have your Christmas menu planned, your tree decorated and your presents wrapped, but have you thought about the potential dangers? Don't worry, I have - and so have lots of other people intent on ensuring you keep well this festive season.</p>
		                      
		           		<p>So here, in no particular order, is my personal selection of the top 10 Christmas health risks. I naturally expect readers to take great exception with the list and suggest their own and probably to accuse me of being a Christmas kill-joy. Not so, but a few sensible precautions could help prevent this being a festive period to forget. A merry - and healthy - Christmas to you all.</p>
		                      
		           		<p>Turkey is probably the biggest thing that goes in your oven each year - if not what else? - and here are some simple ways to make sure it's part of a meal to remember for the right reasons. Don't wash it before cooking. The majority of us do and that simply risks spreading harmful bacteria over worktops. If you have bought a frozen bird then make sure it is fully defrosted with no ice crystals inside. Cook it properly until none of the meat is pink and the juices run clear. You might prefer Delia or Jamie but NHS Choices has advice on cooking turkey. In the interests of balance you should know that summer is the peak time of year for food poisoning.</p>
		                      
		           		<p>It may look festive but dragging a tree - plastic or wooden - into your living room and covering it with electric lights and tiny glass baubles is asking for trouble! According to the Royal Society for the Prevention of Accidents (RoSPA) around 1,000 people visit A&amp;E after calamities with their tree and 350 following problems with Christmas lights. How many years have you been using those lights? Consider a new set, and remember to turn them off at night.</p>
		                      
		           		<p>That line of tea lights flickering on the window ledge won't seem such a good idea if your curtains are set ablaze. Candles cause more than 1,000 house fires and several deaths every year. Fairy lights, decorations and even Christmas cards are also a fire hazard. You are more 50% more likely to die in a house fire at Christmas than any other time. Make sure you don't take the battery out of your smoke alarm to supply a new toy. A scary video of how a Christmas tree can turn into an inferno can be seen here. But remember the majority of house fires start in the kitchen. The UK Fire Service has advice for a safe Christmas.</p>
		                      
		           		<p>There are more accidental falls and traffic accidents in December with bad weather and short daylight hours both playing a part. Snow and ice can be a lethal opponent to even the fittest individual and the best drivers. Last winter there were 76 deaths due to exposure to the cold, 25 fatalities caused by falling on ice or snow and one involving ice skates. The AA has winter driving advice.</p>
		                      
		           		<p>Christmas offers a whole variety of choking hazards from Christmas tree bulbs to decorations. Make sure presents are appropriate for the age and watch out for small items that could be swallowed by toddlers. RoSPA has Christmas safety advice.</p>
		                      
		           		<p>Let's face it most of us will eat too much over Christmas. That's not a problem if it's a one-off, but two out of three adults are overweight or obese. The British Heart Foundation says Christmas lunch can provide more calories than are needed in an entire day and has advice on how to reduce fat and calorie consumption, such as removing skin from turkey and eating slowly.</p>
		                      
		           		<p>Whereas eating too much will simply harm your own waistline, excess alcohol can ruin the lives of others too. Assaults - many fuelled by alcohol - and drink driving both rise over Christmas and New Year. There is also a rise in alcohol poisoning.</p>
		                      
		           		<p>There are always more deaths in winter than other times of year, with causes such as respiratory and circulatory diseases, and infections like flu. There are five times as many emergency admissions for pneumonia in December compared to August and cold weather also triggers a rise in asthma problems . There are more cases of norovirus - or winter vomiting bug - around than in recent years, but we are a long way off the peak of early 2010. Colds, sore throats and painful joints are all more prevalent in winter. There are things you can do to minimise some risks such as have a flu jab, stay warm and wash your hands regularly.</p>
		                      
		           		<p>Let's face it, family arguments are a far more reliable bet than the chances of a white Christmas. The advice from Relate is not to play the blame game with your partner or family (try charades instead); delegate and share responsibilities, confront the issue and not each other and avoid sarcasm. I'll try - honest - but keep in mind the old saying - guests, like fish, begin to smell after three days.</p>
		                      
		           		<p>There's only one thing worse than being surrounded by your relatives at Christmas and that's not being surrounded by them. Someone calls Samaritans every six seconds but the charity says the idea that Christmas is the busiest time of year is something of a myth. Research suggests there is a fall in suicides during the Christmas period followed by an increase just after the New Year. Of course loneliness is just one of many problems people face in the coming weeks. Some will be confronted by a growing mountain of debt early in the New Year as Christmas bills start to pour in. Then there is marital breakdown - more people consider ending their relationship in January than at any other time.</p>
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                <link>http://www.bbc.co.uk/news/health-20785876</link>
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                <pubDate>Sat, 22 Dec 2012 01:22:52 +0000</pubDate>
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                <title>Tumour boy case a parental dilemma</title>
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		           		<p>The outcome of the Neon Roberts court case was never in doubt.</p>
		                      
		           		<p>On one side there was Neon's entire medical team, and the weight of evidence from peer-reviewed cancer studies who agree that he urgently needs radiotherapy; on the other was his mother who failed to produce any evidence at all of alternative treatment.</p>
		                      
		           		<p>The independent cancer expert from whom Mrs Roberts sought a second opinion agreed that the treatment planned for Neon was essential and he would not survive without it.</p>
		                      
		           		<p>The judge, Mr Justice Bodey, showed immense patience and consideration to Sally Roberts throughout the hearing as she first dismissed one legal team and then failed to provide the evidence to back her claim that radiotherapy was unnecessary.</p>
		                      
		           		<p>For me, perhaps the most telling part of the judgement came when Mr Justice Body said &quot;Mrs Roberts has been through a very stressful time; it was every parent's nightmare, but I fear her judgement has gone awry&quot;.</p>
		                      
		           		<p>He said he hoped the parents - who are estranged - would pull together as Neon needed the support of both of them throughout his treatment.</p>
		                      
		           		<p>This case will provoke strong opinions.</p>
		                      
		           		<p>Many will feel Mrs Roberts deserves little sympathy. By missing key medical appointments, and then disappearing with Neon for four days, she has delayed his vital treatment.</p>
		                      
		           		<p>The court heard compelling evidence that his radiotherapy should already have begun.</p>
		                      
		           		<p>Neon has an aggressive brain cancer which experts agree needs radiotherapy and chemotherapy.</p>
		                      
		           		<p>Mr Justice Bodey said the survival rate for children having chemotherapy only was about 35% whereas with radiotherapy it was between 80 and 86%.</p>
		                      
		           		<p>The judge said the combined therapy was the standard treatment and essential to remove any remaining microscopic cancer cells that might remain after two rounds of surgery to remove brain tumours.</p>
		                      
		           		<p>The cancer expert heading the team caring for Neon said he would not give chemotherapy alone as it would be unethical.</p>
		                      
		           		<p>He was referred to in court as Dr A - although Neon has been named, a court order prevents the hospital treating him from being identified.</p>
		                      
		           		<p>Mrs Roberts's legal team said it was her sincere belief that radiotherapy was not in his best interests and might even kill him.</p>
		                      
		           		<p>Her lawyer said she was worried about the impact on his intelligence, that it could make him infertile and that he would put on weight. But the judge said she had produced nothing to support her assertion that thousands of children have survived cancer without radiotherapy.</p>
		                      
		           		<p>Those who seek simply to condemn Sally Roberts should remember that she has been terribly affected by her son's condition.</p>
		                      
		           		<p>The cancer charity CLIC Sargent said it was sometimes difficult for parents to come to terms with the news that life-saving treatment could also damage their children.</p>
		                      
		           		<p>The judge said doctors accepted that radiotherapy had side effects: it could slightly impair intellect and carried some risks of causing infertility but most children coped well - and there would be no quality of life at all if you were dead.</p>
		                      
		           		<p>It is unusual for parents to oppose cancer treatment for their children and, when it does come to court, the names are not given to protect the identity of the youngsters.</p>
		                      
		           		<p>But Mrs Roberts's decision to run away with her son led to a national appeal for his return. Now the name of Neon Roberts will always be linked to this dramatic and sad case.</p>
		                      
		           		<p>Sally Roberts said she could not speak to the media as she has a tie-up with a national newspaper. But her legal team are planning to appeal.</p>
		                      
		           		<p>Neon's treatment will begin next month.</p>
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                <link>http://www.bbc.co.uk/news/health-20820882</link>
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                <pubDate>Fri, 21 Dec 2012 20:47:08 +0000</pubDate>
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                <title>Polio killings a major setback</title>
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		           		<p>The killing of eight polio workers in Pakistan in two days is a brutal reminder of the hurdles facing health teams trying to eradicate the virus from one of its few remaining strongholds.</p>
		                      
		           		<p>Pakistan, along with Afghanistan and Nigeria are the only countries where polio is endemic, which means transmission of the virus has never been halted.</p>
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                <link>http://www.bbc.co.uk/news/health-20785466</link>
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                <pubDate>Wed, 19 Dec 2012 12:55:13 +0000</pubDate>
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