Alzheimer's screening test

The Daily Telegraph reported yesterday that a 30 second screening test for the disease could be around in only 2 years time.
The screening process aimed at people around the age of 40, which would be conducted in GP surgeries using computers, could identify the risk of developing Alzheimer's disease in later life.
Currently cognitive memory tests and brain scans such as PET and SPET are used but the only way to get a full examination of the brain is after death.
Research into the new test by Professor Bunce of Brunel University and has found an effective way of spotting potential sign using patient reaction times. They studied brain scans of healthy men and women ages 44-48 in search for tiny lesions which are similar to those discovered in post mortems of Alzheimer's patients. 15% of 428 participants had these abnormalities which occured in the brain's memory hub (same place as the lesions found in post mortems). The volunteers with the brain lesions had a range of reaction times whereas thoe which healthy brains were more consistient with reaction times.

This test could indicate the development of Alzheimer's disease leading to a quicker diagnosis. These patients could then take preventive stpes such as changing their diet and increasing the amount of exercise they do. If these patients are treated with drugs earlier on it could be that they will never develop the disease. However knowing at the age of 40 that you are likely to develop Alzheimer's could add to the stress of their current life, with the possibility of developing psychological distress or perhaps a depressive illness.

Hospitals are failing to care for the elderly

A report I read today in The Daily Telegraph claimed that a majority of elderly people died within a month of NHS operations because they were not cared for properly. In the survey of 820 patients over the age of 80, 38% were said to be cared for inadequately. Many were malnourished, treated by inadequate doctors and did not receive adequate pain relief. Only a third of the patients were treated by a geriatric specialist.

The key problem in the NHS drawn from this research showed that pain in patients that had difficulty communicating was not managed properly.

The government are determined to make the NHS more patient centered; the patient safety should be at the heart of everything.

An insight into how HIV can be controlled with Anti-retrovirals

1 in 300 people have the ability to control the HIV replication due to a difference in 5 amino acids making a protein called HLA-B. in a genome wide association study, they found 300 points were found to be associated with immine system control of HIV in the region of chromosome 6 which codes for HLA-B.

HLA-B is involved in the immune system when recognising virus infected cells to destroy. The binding pockets on the protein drag and drop peptides from inside the virus onto the cell membrane. CD8 T killer cells then recognise the virus and destroy the cell.

UK scientists think we still have a long way to go before we can develop a new drug or vaccine but we are an important step closer.

BBC News 4th November

Yesterday the Guardian reported, in the developing world, that by focusing on HIV, there are billions of patients who could be receiving cures for other conditions but are not. Victims of the world's most pernicous illnesses could be treated for less than 30p per patient annually however resources are being targeted at HIV, Malaria and TB which infedcts a much smaller fraction of their populations and treatable tropical diseases are being neglected.

'Discovery could lead the way for cancer vaccine' The Daily Telegraph

Researchers at Cambridge University have uncovered how tumour cells protect themselves from the body's immune system. FAP protein found in stromal cells (cell tissue which helps the body to heal) provides a protective shield for the cancerous cells. After running tests on mice, researchers have successfully been able to switch off the gene, coding for the synthesis and production of FAP, which has enabled the immune system to attack the tumour. There is great hope that in the near future this could lead to a vaccine suitable to destroy tumours in various areas of the human body.
We are now only steps away from finding a way to battle against one of the biggest killers, a real break through in medicine.

'New IVF test detects faulty embryos and trebles chance of a healthy baby' - The Times

Scientists have developed a new test called Chromosome Aneuploidy Screening which checks embryos for chromosome abnormalities. The faulty embryos are discarded and only those with a good chance of developing into a healthy foetus will be implanted in the womb. Trials have shown a success rate of 88% which is over 3 times the success rate of current IVF in the UK.

The test costs £2000 a time, on top of the normal £4000 price of IVF. The success rate of the test means that couples opting for private treatment would save thousands as they would probably only require one cycle. It would also cut millions from the NHS's fertility bill as couples are normally offered 3 free cycles (costing the health service £12000). Researchers believe that the test will be available in 2-3years and will be widely used.

1 in 6 couples have difficulty conceiving naturally and IVF clinics treat 37,000 patients a year. This new test will be particularly useful for those women aged over 35 as they are a greater risk of producing genetic abnormalities.

The eggs shown to have abnormalities leading to such conditions as Down's, Edwards' and Turner's syndromes can be discarded. This could be seen as demoralising those living with these conditions; deeming their lives to be less worth living. However it would be in the best will of the child to have a healthy life and would be better for the family caring for the child so a utilitarian would support the new testing. There are also issues surrounding the idea of 'designer babies'; should we be allowed to intervene and 'play God', discarding the embryos and killing off those we don't deem fit enough. It would be easy for this to be developed further until humans have control over their offspring. This is a very controversial issue and would not be supported by a strong Roman Catholic.

'NHS budget rise will feel like a cut' The Guardian

The NHS will get a 0.1% spending increase, which will mean a rise from £104bn to £114bn over the next 4 years.
In reality the increase is very small at a time where costs are rising and healthcare is high in demand; making the rise feel like a budget cut.
The coalition government have had to scrap pledges made by the previous Labour government for free prescription for long term conditions, one to one nursing for cancer patients and only one weeks wait for cancer test results.
Economists say that with the cost of drugs, lifestyle problems (such as obesity) and the ageing population; a 3% increase is needed just to reach a stand still. Also those working for the NHS earning 21,000 or more will have a pay freeze for the following 2 years.

In realistic terms, with the current financial situation, the NHS could not expect a better pay rise and almost all of the other deparments are receiving large cuts too.

Television and Violence

US research has supported the idea that violence in video games and films an on TV has an influence on Boys' aggressive behaviour. The National Institutes of Health conducted a study on 22 boys aged 14-17 who watched 60 violent scenes, ranked from low to moderate. The boys were then asked to rate which clips they thought were more aggressive and their brains were scanned using functional magnetic resonance imaging, to show which parts of the brain are active. Researchers also attached electrodes to their fingers to detect the increase of sweat as an emotional response. They found that the longer the boys watched videos the less they responded to the violence within them.

Dr. Grafman concluded that exposure to violent videos inhibits emotional reactions to similar aggressive videos over time. Normal adolescents will feel fewer emotions over time as they are exposed to similar videos. This could produce more violent reactions from teenagers becasue the emotional component associated with aggression is reduced.
The implications of this research include the idea that teenagers could become less sensitive to violence, more accepting of violence and more likely to commit aggressive acts, which would lead to social problems.

First human to be treated with embryonic stem cells

This week, US doctors at a company 'Geron' in Silicon Valley have been the first allowed to run trials on patients and have spent $170m on looking at spinal injuries. As reported in the Independent (alongside other newspapers and web articles), a man who was partially paralysed a as result of a spinal cord injury has become the first person to be injected with human embryotic stem cells created by IVF. In animal trials paralysed rats regained some movement after stem cell treatment. 14 days after the injury ther stem cells were injected, it is believed that by using stem cells early on there is a greater chance that the nerve cells with be repaired.

Embryonic stem cells can specialise into over 200 different types of body tissues and could be the answer to many uncurable conditions such as Parkinson's and spinal injuries. However in reality there is little clinical evidence that this treatment is safe or effective and it will take years of work to assess this. The phase I trials will analyse the safety.

The use of embryonic stem cells is a controversial issue. Some people (particularly Roman Catholics) believe that the soul is implanted from the point of conception and therefore the embryo is a person in it's own right. Discarding the embryo once the stell cells have been remove would be seen as murder and morally wrong. However many others would believe that although the embryo deserves respect; the human suffering from a fatal condition deserves more respect so we can justify using the stem cells from the embryo to ease the suffering of a human being. This debate is on-going and there will never be a universal opinion. I personally believe we are taking a step in the right direction; it is in our best interest to help those who have uncurable conditions and to minimise the amount of suffering. I hope to see more successful results from the research in the future.

A difficult time at the hospice

Yesterday I was doing my fortnightly shift at Garden House Hospice. As part of duty, working in the small beverage room, I have to give each patient a jug of fresh water and offer tea and coffee to relatives. One of the nurses made me aware when I saw her for a take over that an inpatient was dying. I went into his room to deliver his water, he looked peaceful attached to a machine although I did feel a little bit uncomfortable. Later on, I met the voluntary organiser from Elmside, who I was surprised to see in the hopsice. It wasn't until I spoke to her that I realised, that the dying man, was her husband. It was when I made those connections that I began to feel emotional; this poor lady has had the worst couple of days of her life, to be widowed at the age of 40 with very young children, in the week that she had taken off work to go on a family holiday seemed all too much. I cannot even think of how difficult that must be, feeling isolated, helpless, broken, alone.
From seeing his peaceful body in bed to having the realisation that this is someone's husband, brother, father, adds more meaning to the situation. I think it is harder to see someone you know struggle and grieve than someone you have never met.
This has been an eye opener to the complications and emotional strains with dealing with death, it so important to deal with the family's spiritual needs sensitively; allowing them to grieve in peace but making sure they know there is someone there for them.

I-Addiction

A Chinese study I found on the Student BMJ site, has suggested that those who spend a lot of time on the internet are at greater risk of addiction and harm to their mental health. The researchers measured this using a questionnaire for adolecents. This is a self report method, so may not be the most accurate form of analysing addictive behaviour as participants could exaggerate their answers or lie. 6.7% of the 208 teenagers used in the study were said to have an internet addiction, the research could be culturally bias if they are using only Chinese participants and may find different addiction rates if tested in different cultures, this would test how universal the results are.
This study did not look at depresive symptoms or suicidal thoughts however other research had suggested those with an internet addiction are more likely to have these mental health issues.