Monday 10 December 2012

'Fat' drug could treat epilepsy


A substance made by the body when it uses fat as fuel could provide a new way of treating epilepsy, experts hope.
Researchers in London who have been carrying out preliminary tests of the fatty acid treatment, report their findings in Neuropharmacology journal.
They came up with the idea because of a special diet used by some children with severe, drug resistant epilepsy to help manage their condition.
The ketogenic diet is high in fat and low in carbohydrate.
The high fat, low carbohydrate diet is thought to mimic aspects of starvation by forcing the body to burn fats rather than carbohydrates.

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Although often effective, the diet has attracted criticism, as side-effects can be significant and potentially lead to constipation, hypoglycaemia, retarded growth and bone fractures.
By pinpointing fatty acids in the ketogenic diet that are effective in controlling epilepsy, researchers hope they can develop a pill for children and adults that could provide similar epilepsy control without the side-effects.
In early trials, the scientists, from Royal Holloway and University College London, say they have identified fatty acids that look like good candidates for the job.
They found that not only did some of the fatty acids outperform a regular epilepsy medication called valproate in controlling seizures in animals, they also had fewer side-effects.

But many more tests are needed to determine if the treatment would be safe and effective in humans.
Prof Matthew Walker, from the Institute of Neurology, University College London, said: "Epilepsy affects over 50 million people worldwide and approximately a third of these people have epilepsy that is not adequately controlled by our present treatments.
"This discovery offers a whole new approach to the treatment of drug-resistant epilepsies in children and adults."
Simon Wigglesworth, deputy chief executive at Epilepsy Action, said: "We know the ketogenic diet can be a highly effective treatment for children with difficult to control epilepsy and it is starting to be used for adults.
"The diet is high in fats and low in carbohydrates and the balance of the diet needs to be carefully worked out for each child. Although some children manage the diet very well, others find the diet unpleasant and difficult to follow. Children can also experience side-effects including constipation and weight loss.
"The identification of these fatty acids is an exciting breakthrough. The research means that children and adults with epilepsy could potentially benefit from the science behind the ketogenic diet without dramatically altering their eating habits or experiencing unpleasant side-effects.
"We look forward to seeing how this research progresses."
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cancer networks


Clinical networks which oversee the care of cancer, heart and stroke patients in the NHS have had their budgets and staff cut, figures show.
Some of the groups say they are postponing projects due to uncertainty from the changes made in England.
The data comes as a result of Freedom Of Information (FOI) questions put to the networks by Labour.
Ministers are confident the networks - set up to improve care and prevention of disease - will continue to do so.
But the shadow care minister, Liz Kendall, claimed the figures showed the networks were "in chaos" and facing "huge uncertainty about their future".
There are currently 28 cancer networks and 28 stroke and heart networks - both areas will be condensed into 12 groups across England after April, with diabetes joining heart and stroke care.
'Scaled back'
More than 75% of the clinical networks responded to the FOI request.
The cancer teams said funding had been cut by around 25%, and 73 staff had been lost since 2009.
The teams looking after heart and stroke care said their funding had been cut by 12% and 38 posts had gone in the past three years.

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The fact that the Board is putting £42m into the networks is a sign of how important we think they are.”
Prof Sir Mike RichardsNHS Commissioning Board
Ms Kendall said: "Ministers have repeatedly promised to protect the funding for clinical networks. The government should be working to support these local specialists."
The networks have been credited with improving and streamlining care for patients at a local level, and making their treatment more straightforward if they have to attend several hospitals.
Examples of achievements include reorganising stroke services so fewer patients die, and speeding up X-ray results for faster cancer diagnosis.
In the FOI responses, the networks say programmes they use to support doctors and nurses are already being scaled back - examples given include a chemotherapy nurse post not being replaced and community training programmes in rehabilitation after stroke no longer running.
'Unsettling times'
An oncologist from Yorkshire, where the new network will cover the whole of the Yorkshire and Humber region, said: "I never dreamt that a leviathan such as what is being proposed would be the plan.
"The new network will be too big to be able to reflect local capabilities and needs, yet too small to have the authority of national guidelines."
The NHS Commissioning Board plans to give funding worth £42m to four clinical network areas from April.
They will be cancer, cardiovascular disease, maternity and children's services, and mental health -including dementia. Posts for new clinical directors for different disease areas are due to be advertised next week.
The national director for cancer, Prof Sir Mike Richards, who will be the board's director for reducing premature mortality, acknowledged that cancer networks would have a "smaller proportion" of the networks' budget in the future - and he admitted the coming weeks would be "unsettling and difficult" for staff who might receive notices of their jobs being at risk.
He said: "Everybody recognises that the networks have played a huge part in delivering change. They have been a very important channel between the patients and doctors, and the Department of Health.
"I am confident that in the future the networks will continue to play their important role.
"The fact that the Board is putting £42m into the networks, as against the current £33m, is a good sign of how important we think they are.
"Although cancer networks will have a smaller proportion of the budget in the future, there are still backroom efficiencies that can be made, to make things work more effectively. Increasing the footprint of each network will make them more cost-efficient.
"I do recognise this is a time of maximum uncertainty, particularly with staff being put on notice. The next few weeks will be difficult."
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Saturday 8 December 2012

Lung disease patient


Over 1,000 doctors involved in the care of people with lung disease have expressed "grave concern" about the future of NHS care for their patients.
They have signed a letter to the head of the new NHS Commissioning Board in England, Sir David Nicholson.
It says staff are "disappointed and angry" that efforts to improve care for people with lung disease and asthma might "be left behind in the new NHS".
The Department of Health said it wanted "maximally effective" local services.
As part of the government's changes to the NHS in England, networks of doctors and nurses who organise care for the big killer diseases at a regional level are being restructured.
This is causing particular concern among professionals who look after patients with lung disease, because the 10 regional boards who had driven clinical improvements will no longer have support or funding after next April.

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We've very disappointed and angry that this apparatus is being dismantled. ”
Prof Mike MorganBritish Thoracic Society
The medical experts say treatment has been transformed in recent years, leading to better organisation of services such as oxygen delivery for patients who need it at home.
The letter says: "The respiratory improvement programme started by the Department of Health just two years ago is starting to make real progress in improving respiratory care, whilst also saving the NHS money.
"Yet the support and funding for all this work is being withdrawn from April 2013, just at the point when patients are about to really benefit.
"We are concerned that patients living with respiratory disease will be left behind in the new NHS."
Heartbreaking
The letter was put together during a conference organised by the British Thoracic Society in London this week.
One of the signatories, Prof Mike Morgan, who works in Leicester, said: "We've very disappointed that this apparatus is being dismantled.
"The government has identified respiratory disease as a priority, but appears to be removing the infrastructure that supports it.
"We've worked hard alongside patients to improve standards of care, and it's heartbreaking to see this work destroyed unnecessarily.
"This lack of supervision of the improvement of care won't work in future if it's left to its own devices."
The British Lung Foundation (BLF) says one in five people in the UK suffer from lung disease.
This includes three million people with Chronic Obstructive Pulmonary Disease (COPD) and four and a half million who have asthma.
'Unintelligible'
The BLF's chief executive, Dr Penny Woods, said: "At the moment, respiratory care in this country lags behind the rest of the developed world.
"Our patients are writing to MPs to express their concerns. We're worried that if these networks aren't continued, the variation in standards of care will get worse."
Neil Churchill, chief executive of Asthma UK, said: "The loss of networks and a coherent improvement programme will make it harder to reduce deaths and improve efficiency for respiratory diseases.
"Given their cost in lives and in pounds, this is simply unintelligible to doctors, nurses and patients. We have just three months to put this right."
A spokesman for the Commissioning Board said: "We fully recognise that respiratory disease is a high priority both for reducing premature mortality and improving long term quality of life.
"We look forward to working with the clinical community and leading respiratory charities on making local services maximally effective."
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French sperm count 'falls by a third


The sperm count of French men fell by a third between 1989 and 2005, a study suggests.
The semen of more than 26,600 French men was tested in the study, reported in the journal Human Reproduction.
The number of millions of spermatozoa per millilitre fell by 32.3%, a rate of about 1.9% a year. And the percentage of normally shaped sperm fell by 33.4%.
The average sperm count remained within the fertile range, but experts want to see more research into possible causes.
One of the paper's authors, Dr Joelle Le Moal, an environmental health epidemiologist, said: "To our knowledge, this is the first study concluding a severe and general decrease in sperm concentration and morphology at the scale of a whole country over a substantial period.
"This constitutes a serious public health warning."

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Something in our modern lifestyle, diet or environment like chemical exposure, is causing this.”
Prof Richard SharpeUniversity of Edinburgh
But Dr Allan Pacey, senior lecturer in andrology at the University of Sheffield, said: "The change in sperm concentration described, 73.6 to 49.9 million per millilitre [on average for a 35-year-old], is still well within the normal range and above the lower threshold of concern used by doctors which is suggestive of male infertility, 15 million per millilitre."
There has much been debate in the past 20 years over whether sperm quality has decreased, with research supporting both sides of the controversy. This latest research adds weight to the numerous European studies that suggest one in five young men has a sperm count low enough to impair fertility.
Prof Richard Sharpe, from the University of Edinburgh, said: "Something in our modern lifestyle, diet or environment like chemical exposure, is causing this.
"We still do not know which are the most important factors, but perhaps the most likely is a combination, a double whammy of changes, such as a high-fat diet combined with increased environmental chemical exposures."
The study analysed data from the French database Fivnat, which logs information from 126 assisted reproduction centres. Researchers examined semen samples provided by men aged between 18-70 whose partners were undergoing fertility treatment because of blocked or missing fallopian tubes.
'Jury out'
As the study took place over a period of years, it is important that methods remained the same for comparison- but critics have questioned this.
Dr Pacey said: "In the paper, the authors claim that the methods for measurement of sperm concentration and motility 'have not changed noticeably during the study period', yet to me this is an odd thing to say as in my experience they have changed remarkably everywhere else in the world.
"I would argue that the 'jury is still out' on this issue."
While the study took into account factors that can affect sperm quality, such as age, researchers were unable to control for socio-economic factors, smoking or weight, which have been shown to have a major impact.
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