iblog

Jeanne: Surveys have suggested that a lack of regulation in some sectors of the cosmetic surgery market has led to the emergence of ‘cowboy’ attitudes amongst some practitioners. According to representatives from the British Association of Aesthetic Plastic Surgeons, treatments such as Botox are currently available far too easily and offered by ‘professionals’ with rather dubious qualifications. The British government has argued that the plastic surgery industry is perfectly capable of regulating itself.

However, industry insiders are anything but convinced. Douglas McGeorge, head of the British Association of Aesthetic Plastic Surgeons, has highlighted the lack of regulation in the sector in a recent interview. Speaking to the media, he stated:

“Basically if you wanted to have Botox administered on a park bench, you could do it, these days. To foster a ‘wild west’ approach is not only an affront to reputable professionals who follow the rules, but ultimately creates an unsafe environment for the public. Botox has to be prescribed, so you get your voucher and can take it to a practitioner to get the treatment done. However, the treatment is paid for long before any counselling takes place - before a decision can be made as to whether it is appropriate for that person.”

This lack of regulation has led to the emergence of a number of other risky practices. These include the sale of products and services via the Internet. One such product, Isolagen, became ‘available’ online to UK customers 3 months ago. This was despite the fact that the product had been banned in the United States as early as in 1999. Describing the situation, Mr. McGeorge stated:

“The public needs to be realistic about the outcomes they can expect from new cosmetic treatments, at least until solid clinical evidence of their efficacy exists.”

However, representatives from the UK government believe that self-regulation will be sufficient to prevent the sale of such products in the future. One spokesperson at the Department of Health stated that the regulation of the sector was a ‘top priority for the government:

“We have every confidence that self-regulation will result in improvements for people choosing these non-surgical cosmetic treatments. Our plans for change are driven by the need to ensure that we only regulate in cases where the reduction in risks to safety arising from public regulation clearly outweigh the costs and burdens that regulation brings. In this case we feel that we can best protect people who wish to have these treatments by using other tools at our disposal.”

Rushda: New benefits of chocolate were highlighted earlier this week when researchers found that eating dark chocolate daily significantly helps those who suffer from chronic fatigue. The study found that those patients who ate chocolate with a high cocoa content were less tired than those who ate white chocolate which had been dyed brown.

The research was conducted at Hull York Medical School where experts confirmed that eating chocolate increased serotonin levels in the brain, this perhaps being the main cause of its effect in alleviating fatigue. The study involved a trial of ten patients who ate a specified amount of chocolate daily for a month - some taking white chocolate that had been dyed to look like dark, and some eating real dark chocolate. After a couple of months, they were given the other type of chocolate. It was found that those who started eating real dark chocolate felt less tired, whilst those who went off it felt more tired than before.

Even though the study was small, head of research Professor Atkin was surprised at the results which undeniably suggested a strong link between fatigue and dark chocolate consumption. He explains:

“Dark chocolate is high in polyphenols, which have been associated with health benefits such as a reduction in blood pressure. Also, high polyphenols appear to improve levels of serotonin in the brain, which has been linked with chronic fatigue syndrome, and that may be a mechanism.”

Though this may be great news, especially for chocolate lovers, experts still advise that chocolate should be eaten in moderation.

Jeanne: The US Senate and House of Representatives have announced a plan to broaden affordable healthcare provision for some of America’s neediest children. The plan aims to provide further medical services to 4 million children who would otherwise need to go without. However, it appears that the US President, George W. Bush, will veto any such legislation. This is in spite of a tragic incident earlier this year, which highlighted the need for affordable health care for America’s poor.

In February, a 12-year-old boy, Deamonte Driver, died after an untreated tooth abscess which spread to his brain. His family lacked medical insurance and was unable to afford private dental treatment. His death had an enormous impact on the local community. According to Gina James, the principal at Deamonte’s school,

“The thing about Deamonte was his smile, he was always smiling. Everyone here was shocked. They couldn’t understand how he could have toothache and then die. We sometimes give the little kids candy as a reward; well, for a while they stopped taking it because they would say ‘if I get a cavity, will I die?”

However, as tragic as Deamonte’s story is, it’s a case that has been repeated time and time again across the United States. Whilst the poorest are offered medical benefits in the form of Medicaid, not all dentists and doctors accept Medicaid patients. It’s a scandal which has appeared to unite American politicians across party lines. A bill to extend medical benefits to cover another 4 million children was passed in the Senate with a majority of 38 votes. However, the bill failed to pass through the House of Representatives with a two-thirds majority, meaning the President can still veto it. And it is likely that George W. Bush will veto the bill when presented with it. Mr. Bush is a firm believer in the private health care system and opposes the proposed legislation on the grounds that it:

“directs scarce funding to higher incomes at the expense of poor families.”

This statement appears somewhat confusing; after all, we’d expect the legislation to help poor families. As one analyst put it:

“In effect, both supporters and opponents of the bill say the other side risks health coverage for children.”

Jeanne: Scientists have found that heavy exercise could raise the risk of a woman suffering a miscarriage during pregnancy. Danish researchers found that a number of different forms of exercise, from racquet sports to jogging, trebled one’s risk of a miscarriage. These findings come as a bit of a surprise given that most doctors and health advisors encourage exercise among pregnant women in order to prevent excessive weight gain and the onset of high blood pressure.

The researchers at the University of Southern Denmark surveyed 90,000 women on their exercise regimes and the progress of their pregnancies. Not only were women who played ‘high impact’ sports such as ball games more likely to suffer a miscarriage, but those who exercised for more than seven and a half hours a week were subject to a similar risk as well. However, the relationship between exercise and miscarriage risks reduced significantly after the first eighteen weeks of pregnancy. Commenting in the British Journal of Obstetrics and Gynaecology, the scientists undertaking the survey stated:

“The results of this study suggest that leisure time exercise during pregnancy, and particularly high-impact exercise, is associated with an increased risk of miscarriage in the early stage of pregnancy.”

However, critics of the survey have been quick to suggest that the methods employed during the survey were fundamentally flawed. The study required women to recall the amount of exercise they undertook during the survey. However, the scientists had no way of corroborating the information provided to them by their subjects. In addition, women’s advocates have argued that such findings could inadvertently have an adverse impact on the health of pregnant women. In particular, critics argue that a lack of exercise could lead to high obesity rates among pregnant women. This in turn would have an adverse effect on the health of unborn children. According to Alison Merry from the organisation, Blooming Fit, which plans exercise and fitness programs for pregnant women,

“The benefits of exercising during pregnancy are clear - it improves the cardiovascular system, and maintains muscle tone. While I would say that getting a hockey ball in the stomach is not a good idea, I can’t think of any reason why jogging would be harmful.”

She encouraged women to engage in activities such as swimming – this form of exercise has been shown to have particular benefits for pregnant women.

Jeanne: It is yet another reminder of the dire humanitarian situation in Iraq. A woman has died of cholera, a deadly disease that is rare even in some of the poorest parts of the third world. It is the first death in the capital, following a recent cholera outbreak in the country. The Iraqi Health Ministry reported incidences of the disease in northern parts of the country last month. So far there have been 11 deaths from cholera across Iraq and some 2,000 people have been diagnosed with the illness. The dead woman was a resident of one of the poorest districts of Baghdad. Medical sources suggest that other members of her family have also contracted the illness.

The World Health Organisation (WHO) fears that this humanitarian crisis may escalate if greater efforts aren’t made to: combat the epidemic, provide Iraqis with clean water and rebuild the country’s sewage treatment plants. This is particularly important as the British charity, Oxfam, has found that 70% of Iraqis do not have access to clean water. According to the director of the Basra health ministry, Dr. Ryadh Abdul Ameer, many water treatment plants operate without chlorine, a chemical used to purify water and destroy harmful bacteria:

“We are suffering from a shortage of chlorine, which is sometimes zero. Chlorine is essential to disinfect the water. The carrier for this disease is 99% water, and chlorine is essential to disinfect the water. The water is dangerous if the chlorine level is low. Most of the water stations in Basra are not functioning now.”

It therefore comes as little surprise that there have been more than 29,000 recorded cases of waterborne diseases in the country since early August.

Cholera is a waterborne disease which affects the intestines. One in twenty people who contract the condition become severely ill. The disease can be treated with medications. However, medicines are scarce in Iraq. Continuing violence in the country has also made it hard for qualified medical personnel to reach the affected areas in time. The American authorities in Iraq have stated that every effort is being made to deal with the situation. Foreign nationals in Iraq have been advised to boil water thoroughly before consumption in order to kill any bacteria which may be present.

Rushda: New research from University of Warwick and University College London has found that those people who sleep too much or sleep too little are at double the risk for fatal cardiovascular disease. They have found that contrary to common opinion, good sleep is actually vital for health and those who consistently sleep for around 7 hours a day are at the optimum level for good health.

The study consisted in examining the sleeping patterns and death rates of over 10,000 people over a decade. The results, which are to be presented to the British Sleep Society, suggest that those who cut down their sleep to five hours have a doubled risk of developing the heart disease, this also applying to those who slept for over eight. Many factors were taken into account, including “age, sex, marital status, employment grade, smoking status and physical activity” and it was found that even when all things were considered, there was still a striking correlation between bad sleep and risk.

As researcher Professor Francesco Cappuccio explains:

“Fewer hours sleep and greater levels of sleep disturbance have become widespread in industrialised societies. This change, largely the result of sleep curtailment to create more time for leisure and shift-work, has meant that reports of fatigue, tiredness and excessive daytime sleepiness are more common than a few decades ago. Sleep represents the daily process of physiological restitution and recovery, and lack of sleep has far-reaching effects.”

Cappuccio says that bad sleep is not just increasing the risk of heart disease but has all kinds of other effects related to poor health. For example, a lack of sleep is linked to excess weight gain, high blood pressure and type 2 diabetes. Furthermore, staying in bed too long is linked with depression and irritability. The researcher maintains that the ideal is a consistent 7 hours a night for optimal mental and physical health.

However, Dr Neil Stanley, a sleep expert from from Norfolk and Norwich University Hospital, says that sleeping is an individual thing and everyone has their optimum level. What is most important is being consistent and not going too far over or too far under the right amount for you. He says:

“Sleep need is like height or shoe size: we all have an individual one, and if we sleep less or more than that then there are consequences to pay.”

As research progresses, it is becoming clearer how important sleep really is. Many experts believe that public health messages, which currently only seem to focus on diet and exercise, should also include information about sleep, which is almost if not as important.

Jeanne: Researchers have found that certain strains of bacteria can gain virulence in the weightless conditions associated with space flight. Scientists examined the effects of space flight on a strain of salmonella during the 2006 Atlantis mission. Space travel, they found, increased the likelihood that the bacteria would kill infected mice by 300%. This sharp increase in the rodents’ mortality rate was due in part to the fact that weightlessness appeared to cause the bacteria to undergo genetic mutations such that they became more dangerous.

The study was carried out by scientists at America’s National Academy of Sciences. The findings are particularly important given that the US space agency, NASA, is currently working on a project to land a manned craft on Mars in the not-too-distant future. The strain of salmonella investigated during the study, Salmonella typhimurium, is one of the most virulent forms of the deadly bacteria and is often very difficult to treat, even with antibiotics. Researchers have therefore emphasised the importance of maintaining good hygiene in the cramped conditions of a spacecraft. Commenting on the matter, Cheryl Nickerson, from the University of Arizona’s Center for Infectious Diseases and Vaccinology stated:

“Wherever humans go, microbes go; you can’t sterilise humans. Wherever we go, under the oceans or orbiting the Earth, the microbes go with us, and it’s important that we understand… how they’re going to change. These bugs can sense where they are by changes in their environment. The minute they sense a different environment, they change their genetic machinery so they can survive.”

Scientists hope that their research will bring them closer to developing a vaccine for the deadly disease. Genetic mutations in salmonella bacteria appear to have been controlled by a protein known as Hfq. The team hopes that drugs specifically designed to manipulate the protein could serve as a vaccine against salmonella. Treatments for salmonella are, at the moment, quite limited. Whilst mild cases of salmonella do not require specific medical attention, the condition can be fatal in certain instances. The disease is usually contracted through the consumption of contaminated food such as poultry, eggs and unprocessed milk. Symptoms include sudden nausea, abdominal cramps and bloody diarrhoea. Children and the elderly are particularly susceptible when it comes to contracting salmonella.

Rushda: The River Cam in Cambridge is well known, especially amongst the students, for punting and lazing on the banks, and indeed many of us cross it every day without a second thought. However, recent studies have found that the river contains certain viruses which may actually help combat serious infectious diseases such as MRSA.

A whole bunch of special viruses have been found in the river lately which have been said to be able to treat stomach infections in mice. This is great news as eventually they could be used as antibiotics in medicine for human use. The viruses, known as bacteriophages, were isolated from the water and tested by scientists at the Wellcome Trust Sanger Institute. The results show that a bacteriophage attaches itself to a bacterial cell and effectively explodes it, but leaves healthy cells intact. The effect is particularly striking when different types of bacteriophages are combined.

As Dr Pickard from the research team explains, the river Cam is particular suited to finding these viruses because of the ideal water environment. He believes that scientists can eventually isolate the viruses for human use and they be very helpful in fighting antibiotic-resistant diseases such as MRSA. He says:

“Conventional antibiotic treatment has led to MRSA and other superbug infections becoming not only more prevalent but also more infectious and dangerous. Bacteriophage therapy offers an alternative that needs to be taken more seriously in Western Europe.”

As a Cambridge student who’s always seen the river Cam as nothing but dirty, the news that it holds special disease-fighting secrets comes as a huge and welcoming surprise.

Jeanne: Research has suggested that diets rich in carbohydrates could increase the risk of liver damage. Heavy consumption of high-glycaemic foods, namely white rice, potatoes and pasta, appear to increase one’s risk of developing a fatty liver. These conclusions were reached by scientists at Boston Children’s Hospital, Massachusetts and have recently been published in the medical journal, Obesity. Mice fed a high-carbohydrate diet were found to have a higher risk of developing the condition. In comparison, mice fed a different diet with an identical caloric content showed no sign of developing fatty-liver syndrome. These findings are particularly alarming given the fact that most people in the Western world have diets that are high in carbohydrates.

So what exactly is fatty-liver syndrome? Simply put , it’s the build up of fatty tissue in the liver. Sufferers, however, remain oblivious to the condition, as there are few physical symptoms. As the Boston researchers found, mice fed a high-carb diet didn’t always demonstrate evidence of overall weight gain. However, the condition can result in liver failure during later life. A low GI (glycaemic index) diet therefore appears to be the key to maintaining a healthy liver. Low GI foods include most fresh fruits, raw (especially leafy) vegetables, and rye or granary bread. These foods lead to smaller and slower spikes in blood sugar and hence insulin (the chemical which tells the body to generate fat).

Researchers hope that their findings will increase awareness of the condition. According to Dr. David Ludwig, the project’s lead scientist:

“This is a silent but dangerous epidemic. Just as type 2 diabetes exploded into our consciousness in the 1990s, so we think fatty liver will in the coming decade.”

There is already significant evidence to suggest that a diet rich in high GI foods can lead to the early onset of type 2 diabetes. According to a spokesperson for the British Diabetics Association:

“There is a place for high-glycaemic carbohydrates in moderation as part of a balanced diet, but there’s good research that eating too much can increase the risk of insulin resistance - and this can lead to serious health problems. However, this study is interesting, as there is other evidence that people who eat a diet rich in high-glycaemic food are more likely to have more body fat.”

Rushda: Our traditional image of a doctor in a long-sleeved white coat will soon be shattered as regulations are coming into place which forbid doctors from wearing such overalls for fear of transmitting bacteria. Far from being the symbol of cleanliness it once was, doctor’s coats have been found to be in fact harbouring germs, and by early next year they will be replaced with different clothing.

According to the Department of Health, it is the cuffs of the traditional coats which are most like to be contaminated, so a new style of coat will be introduced with shorter sleeves. Further rules include the banning of jewellery and watches as these can also transmit infection, and the wearing of ties will also be discouraged.

The new rules for what doctors can and cannot wear are only of a number of steps Health Secretary Alan Johnson is taking to combat the serious problem of infection in hospitals - indeed in some cases of infection, such as MRSA and Clostridium difficile, they have even been known to be fatal.

Cleanliness in hospitals has long been in the cards for improvement but now, finally, a stricter regime will be in place. For example, now all matrons must report hygiene concerns to hospital boards four times a year, and hospital managers will also have a legal duty to report all instances of contamination to Health Protection Agency (HPA). As Mr Johnson says of the new clothing measures:

“I’m determined that patient safety, including cleanliness, should be the first priority of every NHS organisation. Today’s package of measures will give more responsibility to matrons and set guidelines on clothing that will help ensure thorough hand washing and prevent the spread of infections. This is a clear signal to patients that doctors, nurses and other clinical staff are taking their safety seriously.”

For those patients who do become infected by deadly hospital-related diseases, hospitals will be given better guidance over how to deal with them, with more single rooms being used and those with the same infection being treated together.

All this serves as a positive step forward in order to combat the terrible problems of hospital hygiene. Now after the new rules are put in place in England, both Scotland and Wales will be considering similar measures as well.