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Embryos to be screened for cancer

Scientists have been granted permission to screen test tube embryos for an inherited form of cancer. The Human Fertilisation and Embryology Authority (HFEA) approved the screening following a request from couples seeking IVF treatment. The watchdog said there was a strong chance of the genetic bowel cancer being passed from parent to child.

Scientists in London hope using the controversial technique could help to wipe out this type of cancer. A spokeswoman for the authority said: "We can confirm that we have issued a pre-implantation genetic diagnosis licence for that particular condition."

A team at University College London has been granted the licence to screen embryos for the gene that causes familial adenomatous polyposis (FAP). If a parent is a carrier of the gene there is normally a 50% chance it will be passed on to their children. The gene can lead to the development of rectal or colon cancer in early teenage years. Embryos created using IVF can be screened using the pre-implantation genetic diagnosis process. Then only embryos free of the gene will be implanted. copyright BBC Health News Monday 1st November 2004

Natural protein can starve cancer

A protein present in normal body tissue can prevent further growth in tumours, researchers have found. A tumour can grow only if its blood supply also expands to provide it with essential nutrients. The protein, discovered by Bristol University researchers, appears to block the growth of blood vessels past a certain size. The researchers hope their work, published in Cancer Research, will lead to new cancer treatments.

The key protein is one of a group known as vascular endothelial growth factors (VEGF). Most forms of VEGF stimulate blood vessel growth, including the new vessels formed as a tumour begins to develop. However, the Bristol team have identified a form called VEGF 165b, which appears to have the opposite effect by inhibiting the growth of new blood vessels required for tumours to grow above one millimetre in size. The researchers have also found that this form of VEGF is generally found in many normal parts of the body, including the prostate, but not in prostate cancer. They hope it may eventually be possible to use VEGF 165b to prevent tumour growth by effectively starving it of nutrients. The Bristol team believe that the fact that the protein is produced naturally by the body could make it more effective than other anti-cancer agents.

Many new cancer therapies are based on starving the tumour of nutrients by attacking the tumour blood supply rather than the cancer cells. Blocking VEGF using antibodies has recently been shown to be effective in large-scale trials in colorectal cancer in the US. New blood vessel growth is also necessary for many normal body functions. These include the development of the embryo and, in adults, wound healing, the development of the placenta in pregnancy and of muscles during physical training programmes.

However, it is thought that adults can live healthily without blood vessel growth for extended periods of time. This blood vessel growth is controlled by many factors, but VEGF is the most powerful factor. copyright BBC Health News Monday 1st November 2004

Cost of temporary nurses 'soars'

The cost of temporary NHS nursing staff has trebled in six years to more than 600 million, according to a report.
The Royal College of Nursing warns 30,000 nurses leave the profession yearly, and it faces a fragile future.

Efforts to cut agency costs with the creation of an internal NHS temporary nursing pool have had "disappointing" results, it says.

But England's Chief Nursing Officer Chris Beasley said the temporary pool had made a positive difference.

She added that a new deal offering more pay and flexible hours would help the NHS retain staff.

BBC News Online 1/11/04

Vaccine against cervical cancer

A vaccine that prevents infections known to cause cervical cancer could be available to women within three years, UK experts believe. By guarding against human papilloma virus, it could save thousands of lives and may end the need for smears tests. The vaccine would be given to girls before they are sexually active.

Trials have shown a jab can offer 100% protection against strains of HPV linked to about 70% of cervical cancers. Some forms of the HPV virus only cause genital warts, but others cause cervical cancer. It is estimated up to half of the young women in Britain have been infected with a high-risk strain of HPV by the time they are 30. 'High risk' HPV types, strains 16, 18 and 31 and 33, have been found to be present in close to 100% of all cervical cancers, according to the NHS Cancer Screening Programmes.

Since cervical cancer is the second most common cause of cancer death in women worldwide, preventing HPV would save many lives. Both GlaxoSmithKline and Merck Sharp & Dohme have developed a vaccine against HPV and are in a race to get their products approved. The two vaccines are being tested in thousands of women around the world, including the UK. These will seek to confirm the vaccines' effectiveness and safely.BBC Health News Friday 29th October 2004

Children's teeth 'best for years'

Tooth decay among children is at its lowest recorded level since 1983, figures show. The biggest fall was among 15-year-olds, with only 13% suffering from decay compared with 42% in 1983 the Office for National Statistics found. But the survey discovered variations across the UK, with Northern Ireland having the highest level of tooth decay among children. The lowest levels were found in England, followed by Wales.

The survey looked at the dental health of 10,381 children aged five, eight, 12 and 15. The inequalities appeared to be partly linked to the type of school a child attended as well as where they lived in the UK. The survey found 78% of eight-year-olds from "deprived" schools had plaque compared with 70% of "non-deprived" schools. But three-quarters of children in all age groups reported brushing their teeth twice daily, with many using electric toothbrushes. Almost half of 15-year-olds are using mouthwash and sugar-free chewing gum.

Despite the apparent fall in levels of decay in permanent teeth, more children had plaque and gum disease - particularly the boys. About 68% of 15-year-old boys had some plaque, compared to 57% of 15-year-old girls, and 56% of 15-year-old boys had some gingivitis, compared to 48% of girls. And more children are now having fillings. Among eight-year-olds, 52% of obviously decayed permanent teeth had been filled, compared to only 37% 10 years earlier.

The survey found that most parents would prefer their children's decayed permanent teeth to be filled. But the majority of parents would prefer their children's "milk teeth" to be removed rather than filled. Among children aged five, over half had evidence of some early damage to their teeth. BBC Health News Friday 29th October 2004

'Stethoscope' hears kidney stones

Scientists have developed a "smart stethoscope" that can hear when a kidney stone has been successfully broken down by treatment. The device listens to echoes created by shock wave therapy (lithotripsy) to let the doctor know if therapy has worked. Trials at Guy's Hospital in London have showed promising results, saving patients unnecessary repeat therapy and x-ray monitoring. The device was developed along with scientists from Southampton University.

Lithotripsy works by focusing thousands of shock waves onto the kidney stones in an effort to break them into pieces small enough to urinate out of the body or be dissolved by drugs. But there is no way of monitoring how the process is getting on.

Doctors can take an x-ray before and after treatment to see if there is any change in the appearance of the stone. But it is often difficult to tell from these pictures and is more a case of trial and error - if the symptoms return then the patient will need more shock wave therapy.

Professor Tim Leighton and colleagues at the Institute of Sound and Vibration Research at Southampton University, along with kidney experts at Guy's, decided to see whether the echoes produced by the shock waves could be interpreted in some way. Prof Leighton said: "It's a bit like the man on the railway who walks along the length of the train, hitting the metal wheels with a hammer to find out if any are cracked. If the wheel is cracked it gives a duller sound. What we are looking for is a stone to go from being intact at the start of treatment to fragmented at the end of the treatment."

The smart stethoscope is a small probe, similar to those used to trace heart patterns using an ECG, which is taped to the flank of the patient. Just like a normal stethoscope, it picks up sound. From here, the sounds are transmitted to a box the size of a packet of biscuits which amplifies and changes the frequency of the sounds so the doctor can hear them. When the stone is intact the sound given off is a 'tick'. When it has been shattered into small pieces the sound changes to a 'tock'.

Prof Leighton said the device could also be wired up to a computer that would analyse the sounds and display the results using a traffic light system - red for no success, amber for some success and green for fully successful treatment. So far, they have used the device to monitor treatment in 50 patients with kidney stones.

With funding from the Engineering and Physical Science Research Council, the researchers have developed a prototype they say works extremely well. Prof Leighton said: "It's been superbly successful. I have been astounded by how effective it is as a monitor. Plus, it's completely non-invasive. It does not expose you to any radiation." He said it would reduce rather than replace the need for x-rays, which would still be used to locate the stone within the kidney. BBC Health News Saturday 30th October 2004

Complex cause for brittle bones

A mix of bad genes and poor conditions in the womb and early life may be responsible for some cases of brittle bone disease, research suggests. A team from Southampton University has pinpointed a genetic mutation that increases the risk of osteoporosis. However, the gene is more likely to result in disease if the carrier also lacks nutrients before birth, and in their early years. Details appear in the Journal of Clinical Endocrinology and Metabolism.

The Southampton team say their work provides a graphic illustration of the fact that disease is often the result of an interaction between genes and environmental factors, rather than each acting in isolation. They identified a gene which regulates the amount of growth hormone produced by the body, and therefore plays a key role in how well bones develop and grow. However, they also found that the function of the gene appears to be modulated in part by environmental factors in early life.

Carrying the wrong mutation only seemed significantly to increase the risk of osteoporosis if the carrier also had to endure harsh environmental conditions - such as poor nutrition - in the womb, and during the early years of life. The researchers analysed data on a group of 300 Hertfordshire men and women who were born during the 1920s and 30s. Many are still living locally, giving researchers a unique insight into the health of a group of people who are also representative of the population as a whole.

Researcher Professor Cyrus Cooper said: "This has altered our understanding of the complex relationship between genes and the early environment. We have known for a long time that genetic and environmental influences contribute to who we are and our health prospects. This is the first time research has shown the extent to which these early environmental factors (such as maternal nutrition, smoking and exercise) impact on the function of genes which have a key role to play in the development of a healthy skeleton. Although there is a strong genetic contribution to skeletal growth, our work also suggests that the impact of an adverse genetic make-up might be minimised by improving the environment in the womb."

Prof Cooper said the next challenge was to try to pinpoint the best diet and lifestyle that mothers could follow in order to reduce the risk of their children developing brittle bones. BBC Health News Saturday 30th October 2004

EU plans 'risk patients' safety'

Patients could be put at risk by new proposals from the European Union, doctors' leaders have warned. The British Medical Association has warned against a lowering of doctors' standards in the UK. The BMA's Dr Edwin Borman said: "Patients in the UK have different expectations from patients in Germany."

The draft directive - unlikely to come into effect for some two years - aims to create a common internal EU market in various services. There are also concerns the proposed EU Services Directive could bring an excessively business-oriented approach to healthcare. It is designed to ensure free movement of doctors and other providers of services around the EU.

The BMA is lobbying for healthcare to be excluded from the measure as it fears the UK would then not be able to ensure doctors are of the highest standard. It says safeguards must be guaranteed before the plans are approved. Dr Borman, head of the BMA's international committee, said the proposals undermined a country's ability to decide what was in the best interests of patients. "In the UK, clinical guidelines, referral schemes, licence to practice procedures and many other safeguards could all be removed if this directive is adopted," he said. Our concerns must be met if patient safety is to be guaranteed and standards assured across the NHS."

Doctors in Germany, France and Poland say they share UK doctors' fears, although the European Commission denies it is trying to tell individual countries how to run their health services.

At present, each EU member state regulates its own healthcare system - setting the standards, clinical guidelines and rules on qualifications for doctors working within its borders. Under the directive, a member state would have to justify any rules under market requirements, proving them to be "non-discriminatory, necessary or proportional". In addition, a doctor working in the UK who had qualified in another EU country would effectively be regulated by their home country.

At present, anyone working as a doctor in the UK is regulated by the General Medical Council (GMC). The GMC said it was studying the directive's implications and working with the commission to ensure safeguards were in place. BBC Health News Saturday 30th October 2004

Bowel cancer trials 'offer hope'

A treatment breakthrough should mean many more people with bowel cancer can be cured, say experts. When caught early and treated, there is already a good chance of survival, but in some patients the cancer can return. In trials, surgery combined with a new mix of chemotherapy drugs completely cured as many as one in 10 patients - more than with standard chemotherapy. The data was presented by its Paris-based author at a European Society for Medical Oncology meeting in Vienna.

Bowel cancer affects about 38,000 people in the UK each year - mainly over 60s - killing about 14,000. While it is obvious that picking up the disease and treating it as early as possible is the best way to ensure a cure, the success rates have not been high enough.

Dr Rob Glynne-Jones, Macmillan lead clinician at the Mount Vernon Cancer Centre in Middlesex, said: "This is the first time for years that we have had a major advance where patients are actually going to be cured." He said for about 50 years there had been only one chemotherapy treatment available to treat bowel cancer, which was based on a drug called 5-FU. Giving this treatment after surgery to remove the tumour reduces the risk of the cancer coming back by about 30%, he said.

In the trials on 2,246 patients with colon cancer, adding another drug, called oxaliplatin, reduced the risk by a further 25%. Dr Glynne-Jones explained: "I know that may not sound very much, but when you think there are 38,000 patients getting colon cancer a year and probably 10 or 15,000 of them having chemotherapy afterwards, you are going to save quite a lot of lives. For the 30% of those who would have relapsed you are going to reduce that by a quarter. That's quite a big issue," he said. He said adding in the extra drug did make the chemotherapy side-effects worse, but he said patients tended to accept that as a trade off for the increased likelihood of a cure.

In particular, the treatment can cause numbness or tingling in hands by affecting the nerve endings. Oxaliplatin chemotherapy is available in some places in the UK. The National Institute for Clinical Excellence is looking at its availability and is expected to make recommendations in May 2006.

The patients in the study all had stage three bowel cancer, which means the tumour is confined to the bowel and has not spread.

Author of the research, Dr Aimery de Gramont, from the St Antoine Hospital in Paris, told the Vienna conference the findings confirmed the importance of treating early with chemotherapy and surgery. BBC Health News Friday 29th October 2004

'Do not rush into cosmetic surgery'

Plastic surgery aimed at making people look more beautiful could end up leaving them scarred and deformed, unless they do their homework properly, surgeons are warning. The British Association of Aesthetic Plastic Surgeons (BAAPS) has produced a series of guidelines warning people contemplating cosmetic surgery to take their time and go to reputable and approved surgeons.

Simon Withey, consultant plastic surgeon, and member of BAAPS, said he is regularly called upon to try to repair botched surgery. "Every day we will see people who have had problems from operations. In some cases you can do revisional surgery, but in some cases they are scarred for life." Someone I saw went to a clinic in Eastern Europe. She wanted an operation on her eyelid to tighten it up. She chose her surgeon very carefully and got a professor of ocular surgery. But when I saw her she had a scar halfway up the lid and cheek. It brought the lower lid down and the whites of her eyes were showing. It was hideous. Her eyelid will not close properly and she is at risk of scarring to the eye. She can't afford to have the restoration work done privately, so I am having to do it on the NHS."

Mr Withey said another patient had liposuction on her legs in South Africa. Her surgery was so radical that her legs were left badly dimpled and in need of more fat to fill them out. She has already had two operations, but her legs will never be right again," he said. Another had a UK operation on her nose, but Mr Withey said she suffered great skin loss and her nose had been left badly deformed. We can always improve it, but it will never be anywhere as nice as her original nose. It will always be scarred."

Mr Withey, a member of the London Plastic Surgery Association, said patients must ensure they are fully aware of the risks of surgery before agreeing to it. "Most of us who care for our patients will spend two or three sessions of 45 minutes each time going through what their expectations are. Those people going abroad do not get that. They meet a sales person in the UK telling them how much it will cost and how long they will be in South Africa etc, but they do not get anyone talking to them about the risk. Plastic surgery is not formulaic, every patient is different." He said it was in the plastic surgeon's interest, as well as the patient's, to ensure they were fully aware of any potential problems. It is relatively low risk. You are not going to offer high-risk surgery for something which is going to make you more beautiful, but if you choose your patient badly or combine your treatments badly, you can have a disaster."

He said some patients, such as heavy smokers, were often not suitable for surgery as it affected the way their scars healed and that any reputable surgeon would take this into account before agreeing to operate. Mr Withey said surgeons must be prepared to spend time with their patients before and after the operations to ensure they are happy and that they would not agree to operate on patients without an agreed "cool-off period". Most of us are very wary about operating on the wrong people, such as those in a fragile state of mind. These guidelines are a way of saying to people that this is the way that surgeons should behave."

The guidelines advise researching the background and experience of a chosen surgeon, being aware of any risks and possible side-effects and having a realistic idea of what can and cannot be achieved. Jane Elliott, BBC News Health Reporter Friday 29th October 2004

Pylons 'double child cancer risk'

Children living under high-voltage power lines could run double the risk of getting cancer, new research reportedly suggests. Those living within 100 metres of the cables are more likely to suffer from leukaemia, the study indicates. The Childhood Cancer Research Group at Oxford University studied 70,000 children under 15 for the Department of Health report, half of whom had cancer. The seven-year study is reported in the Times and the Independent newspapers.

The research looked at the prevalence of high-voltage power cables near children's homes. Children born or living near the power lines were 1.7 times more likely to contract leukaemia than those in the control group, the research found. Some studies have already shown an association between some types of electromagnetic fields and increased childhood leukaemia.

Research author Dr Gerald Draper said other research suggested power lines might account for 20 to 30 of 500 cases of childhood leukaemia each year. But, he said, his work indicated a far smaller number of cases were affected. The findings were "surprising" and prompted further research, he added. The Department of Health said it would not comment on the findings until Dr Draper submitted his final report. BBC Health News Saturday 30th October 2004

Molecule offers Alzheimer's hope

The development of a molecule which appears to stop a protein forming into clumps could lead to new treatments for Alzheimer's disease, scientists say. The onset of the disease has been linked to plaques which form when fragments of the protein, amyloid-beta, gather into clumps in the brain. The Howard Hughes Medical Institute and Stanford University researchers say lab tests show the molecule stops this. They told the journal Science they hope to begin tests on animals next year.

Despite 30 years of research, scientists have made little progress in developing drugs that inhibit interactions between proteins. This is, in part, because the drug molecules are many times smaller than the proteins, so even if they can attach themselves to the larger molecules they are too small to prevent other proteins binding elsewhere.

The latest study got round this problem by creating a molecule that was able to attach itself to another protein found in the brain cells. Thus the molecule was effectively able to increase its size 15-fold before binding to the amyloid-beta protein fragments - greatly reducing the ability of other fragments to gain a foothold. As a result, the molecule proved effective at reducing protein clumping at concentrations 100 times lower than other blocking agents that have been tested. It also seemed to reduce the toxicity of the rogue protein to nerve cells.

Researcher Dr Isabella Graef told BBC News it was possible that the molecule could be modified to attach itself to even larger 'chaperone' proteins, so that its bulk would be increased 50-fold. At present the work has only been carried out in the lab, but Dr Graef said the team hoped animal tests would start in a year. She said: "We hope that our work will contribute to the development of therapeutic agents that will eventually prevent Alzheimer's, or delay its onset. What we have developed is a completely new way of designing drugs to inhibit protein to protein interactions, not only in neurodegenerative diseases, but also potentially in other diseases, such as HIV and cancer."

Rebecca Wood, chief executive of the Alzheimer's Research Trust, called the research "striking and original". However, she stressed there was no way yet of telling whether the molecule would work in a human brain, or whether interfering with chaperone proteins would produce side effects. There is clearly much work still to be done, and it will be necessary to investigate this drug further in animals such as mice before this potentially valuable method can be tried in patients. This is the first, exciting step in what could be a long path towards a new treatment for Alzheimer's disease."

Professor Clive Ballard, research director of the Alzheimer's Society, said: "There are many exciting approaches currently being investigated to target the accumulation of amyloid, some of which are already being investigate in clinical trials." BBC Health News Friday 29th October 2004

Smaller pill packs 'cut suicides'

Selling painkillers in smaller pack sizes has slashed rates of suicides involving overdoses, research suggests. Legislation, introduced in 1998, cut pack sizes and the number of tablets retailers and pharmacies could sell. Oxford University researchers looked at suicides involving painkillers in the UK between 1993 and 2003. Almost 25% fewer people took fatal aspirin and paracetamol overdoses in the three years after 1998 than before, they told the British Medical Journal.

The Oxford team also found that numbers of tablets taken in non-fatal overdoses of aspirin and paracetamol fell significantly after the legislation. As a result, admissions to liver units for paracetamol poisoning and numbers of related liver transplants also dropped heavily - down by nearly a third (30%) in the four years after the laws came into force.

PAINKILLER SALE RESTRICTIONS Before September 1998: Pharmacies: unrestricted Other retail outlets: max of 24 tablets After September 1998: Pharmacies: max of 32 tablets Other retail outlets: max of 16 tablets Researchers analysed rates of suicides and non-fatal overdoses from paracetamol, salicylates (aspirin) and ibuprofen across the UK between 1993 and 2003.

While overdosing from paracetamol and salicylates - both covered by the new laws - decreased, patterns of overdosing from ibuprofen, which was not targeted in the legislation, remained roughly the same. The researchers argue that although smaller pack sizes do not prevent someone from buying multiple packs from various retailers, many of those who overdose do so impulsively - using tablets to hand in the home. They say their research provides a strong argument for reducing pack sizes still further. ©BBC Health News Thursday 28th October 2004

Prozac use 'risky for children'

Using the anti-depressant Prozac at an early age could lead to emotional problems later in life, US scientists have told the journal Science. Researchers also said pregnant women may also be risking the mental health of their unborn child by using Prozac. A team at Columbia University in New York found young mice given the drug grew up anxious and appeared depressed in tests on their emotional state. But Prozac's makers said care should be taken when interpreting rodent studies. The age of the mice were the equivalent of the last three months of pregnancy to children aged eight.

Prozac is the only anti-depressant which doctors can prescribe to under 18s in the UK. However, doctors have been reluctant to prescribe it to young children, tending to refer children with depression to child psychologists instead. Pregnant women are advised to use the drug with caution.

Last month the US Food and Drug Administration ordered drug manufacturers to put strong labels on anti-depressants such as Prozac after they found they increased the risk of suicide. Columbia University Mark Ansorge, who led the research, said: "Increasingly, these drugs are used to treat emotional disorders in children and pregnant women. However, the long-term effects of these medications on brain development are largely unknown." But he added his study showed that using drugs such as Prozac during the early years of life and late pregnancy "may entail unexpected risks for affective function later in life".

During the study, the scientists injected the mice, which were between four and 21 days old, with Prozac. Nine weeks after their last injection the mice were given tests to reveal their emotional state. They showed a reduced inclination to explore when put in a maze, took longer to start eating when placed in a novel setting and were slower to try escaping from a part of their cage that delivered mild electric shocks. All these behaviours are regarded as signs of anxiety and depression, the team said.

A spokesman for Eli Lilly, the makers of Prozac, said: "Great care should always be taken when trying to interpret mice and rodent studies." And he added the company does not promote the use of Prozac by children. BBC Health News Friday 29th October 2004

Surgical training 'cut by half'

Junior doctors who want to become a surgeon will be fast-tracked through the NHS under a new curriculum. Consultants of the future could be in their early 30s thanks to a halving of the current minimum 12 years that it takes to train after medical school.

The Royal College of Surgeons said its scheme, to be introduced in 2007, would recognise excellence rather than reward time-serving. It denied that the move, hoped to boost staff numbers, was a 'dumbing down'. Mr Hugh Phillips, president of the college said: "Not every surgeon needs to be trained to be a super-specialist doing the most complex surgery in their chosen field. This is not a dumbing down. At present, arrangements for training surgeons are unsatisfactory and we need to make surgical training very much more effective."

Currently, doctors who have graduated from medical schools spend one year as a house officer and then a minimum of two years as a senior house officer (SHO). In practice, the average SHO takes five-and-a-half years to reach the next stage in the surgical career, a specialist registrar job, and only 50% of applicants are successful. Mr Phillips said this was too long and meant many talented surgeons-in-training were stuck at the SHO grade. "Not only is it wasteful of human resources, but it makes for an insecure and difficult time at a crucial stage in the surgeon's career," he said.

On graduation from medical school, the trainee will in the future undertake a two-year foundation programme after which he or she will enter specialist training. The college anticipates it would take most young surgeons only six years to be trained to nationally agreed standards across nine surgical specialties. It has placed a maximum of eight years on the training time.

THE NINE SPECIALTIES SURGEONS WOULD TRAIN IN General surgery Cardiothoracic surgery Neurosurgery Otolaryngology Paediatric surgery Plastic surgery Trauma and orthopaedic surgery Urology Oral and maxillofacial surgery

Restrictions in doctors' working hours as a consequence of the European Working Time Directive means surgical training is seriously compromised, according to the college. Mr Phillip said: "There is still a serious shortfall in the number of consultant surgeons in the UK and yet we need these hard-pressed consultants to train their future colleagues and successors. The new scheme will recognise excellence rather than reward time-serving."

A spokesman from the Department of Health said: "We are working with the Royal College of Surgeons to modernise medical training. The purpose is to make it more focused and contemporary. Patient safety will be at the heart of any changes we make to this training."

Mr Simon Eccles, chair of the British Medical Association's Junior Doctors Committee, said: "Seven years may be enough time for a particularly talented doctor to qualify as a consultant surgeon, but only if the quality of their training is exceptionally high. With recent legal cuts in junior doctors' hours, the NHS and the Royal Colleges need to make sure that the best use is made of the limited training time available. What matters most is that we produce doctors capable of delivering the highest possible standards of care to patients." BBC Health News Thursday 28th October 2004

Abortion row fears over eye cure

US scientists have successfully restored a woman's vision using eye cells taken from aborted foetuses. But while hailing their results as a triumph, the University of Louisville researchers are worried critics will say they are promoting abortion. The UK has clear guidelines to ensure people cannot conceive and terminate a baby to treat another person, but similar rules do not exist in the US. The findings appear in New Scientist magazine.

Elisabeth Bryant's sight was restored by a transplant of retinal cells taken from the eyes of aborted foetuses. The transformation appears not to have been a short-term effect, as the team who carried out the operation had feared. Before the experimental surgery on her left eye, Elisabeth, who was 63 at the time, could barely see anything with it. "Now I can see people's eyes, noses and mouths when they're sitting across the room from me," she told New Scientist.

So far, six patients with degenerative diseases of the eye - either advanced retinitis pigmentosa or another disease called macular degeneration - have received similar transplants in the US. Dr Robert Aramant, who developed the technique at the University of Louisville, said: "We have shown the way. It is possible to reverse these incurable diseases." But his colleague Mr Norman Radtke, the surgeon who carried out the transplants, said: "People are going to claim that we are promoting abortion." The team has been given the go-ahead by the US Food and Drug Administration to carry out more transplants on people with less advanced disease.

Earlier this week, Canadian researchers from the University of Toronto announced that they had shown that retinal stem cells taken from adults were capable of forming the cells needed to repair damaged eyes. Although this method has only been tested in animals, the scientists are hopeful that it could be used to treat humans.

David Wong, chairman of the scientific committee of the Royal College of Ophthalmologists, said: "As ophthalmologists, we welcome research into stem cells as indeed it offers hope for patients suffering from degenerative conditions such as retinitis pigmentosa and macular degeneration. Particularly exciting is the fact that the Toronto group could harvest stem cells from adult human eyes," he said, which would overcome some of the ethical concerns.

A spokesman from Comment on Reproductive Ethics said using tissues from aborted foetuses was totally unnecessary. "Why bother doing something that's ethically difficult or unacceptable when you can take stem cells from adults?" he said. BBC Health News Wednesday 27th October 2004

Asthma risk 'fixed before birth'

The chances of a child developing asthma or other allergies may largely be fixed by the time they are born, a study suggests. Researchers found babies with high levels of antibodies in their umbilical cord blood were more at risk. Antibodies are a sign that the immune system has begun to respond to the irritants that cause allergies. The research, by the David Hide Asthma and Allergy Centre in Isle of Wight, is published in Thorax.

The researchers analysed data on cord blood serum samples taken from more than 1,300 children born between 1989 and 1990. Each sample was measured for levels of a chemical called IgE, which is produced by the immune system in response to the presence of allergens, such as pet waste, house dust mites and grass pollen. The children were also assessed at the ages of one, two, four and 10 years of age to find out if they had developed allergies and/or asthma. By the age of four, one in five children had become sensitised to allergens, and by the age of 10 more than one in four (27%) had done so.

Children who had high umbilical cord blood levels of IgE at birth were around twice as likely to have become sensitised. One in 10 of the children had been diagnosed with asthma by the time they were one to two years old, and by the age of four, one in seven (15.2%) of the children had asthma. Almost 13% of the children had asthma by the time they were 10.

High IgE cord blood levels were not associated with the development of asthma up to the age of four. But children with high IgE levels in their umbilical cord blood were around 66% more likely to have a diagnosis of asthma by the age of 10.

The researchers also found that children who showed no signs at all of an increased sensitivity to allergens in their early years were three times more likely to develop asthma if they had high levels of the antibodies in their umbilical cord blood. This apparent paradox can occur because in some cases of asthma the immune system triggers airway inflammation without any specific reaction to a known allergen.

The researchers say dramatic changes in the immune system occur during pregnancy - and the immune response of the foetus - to make IgE antibodies - can start as early as the 11th week. This can be influenced by the mother's environment as the same factors that impact on her may reach the baby via the placenta. They suggest their findings indicate that foetal immune system programming could be more important than what happens after birth in influencing the development of childhood allergies.

Lead researcher Dr Hasan Arshad told BBC News Online: "Over the last 10-15 years a lot of research has focussed on the early life influences that may contribute to the development of asthma in a child, but it may be that we have to go back even further and look at the pregnant woman's environment."

However, Dr Seif Shaheen, of King's College London and Asthma UK Research Fellow, said it would be wrong to overlook the impact of exposure to allergens following birth. "Whilst there is an increasing body of evidence that the environment in the womb may influence the development of atopy (allergy) and asthma, it is also likely that the environment once the child is born plays an important role too. We are all born, to a lesser or greater extent, with our immune system skewed towards an allergic type response. Environmental exposures after birth are likely to determine whether this allergic tendency carries on through childhood or disappears."

Professor Andrew Peacock, of the British Thoracic Society, said: "This research indicates that umbilical cord blood may hold valuable clues as to why one in five children in the UK have asthma and one in three adults are developing an allergy. More research needs to be done in this area if we are to have any chance of turning round the four fold increase in allergic conditions that we have seen take place in the UK over the last 20 years." BBC Health News Wednesday 27th October 2004

People with psoriasis 'shunned'

People with psoriasis are being treated as social outcasts, survey findings show. Telephone interviews with more than 5,000 European people revealed half would not kiss, swim with or eat food prepared by someone with psoriasis. This was despite most realising this skin condition is not contagious. Friday 29 October is the first world psoriasis day, aimed at increasing awareness and breaking down prejudices about this common skin disease.

Taylor Nelson Sofres surveyed 5,029 people from France, German, Italy, Spain and the UK. Most knew that it was a type of skin disease but, less than a third of those questioned knew that psoriasis was a common disorder, affecting one in every 50 people. Nearly two in 10 people thought poor hygiene was the root cause of psoriasis, even though three-quarters correctly knew that the condition is partly inherited and partly down to environmental factors. Many would not want to have close physical contact, such as hugging, with someone who had psoriasis, men more so than women.

Michele Corvest, founder of APLCP - Association for the Fight Against Psoriasis - said: "I was shocked to see that half of the people surveyed would refuse to kiss or hug me or eat a sandwich from my hand." Lars Ettarp, president of the International Federation of Psoriasis Foundations behind World Psoriasis Day, said: "For the 125million people worldwide who suffer from psoriasis, life can be extremely difficult and we are still discriminated against due to the unsightly appearance of our skin. We want a better standard of care for people with psoriasis." BBC Health News Thursday 28th October 2004

School meals 'must be healthier'

Ministers must do more to protect pupils from primary school dinners high in fat and salt, a report says. The Soil Association, which promotes organic farming, said it had analysed five typical lunches. Children eating such meals every day would consume 40% more salt, 28% more saturated fat and 20% more sugar than recommended, it said. The Department of Education said it had started a monitoring exercise to check the quality of food served in primary schools. The warning comes amid widespread concern over childhood obesity. A "typical" school meal including cheese fritters, roast potatoes, peas and flapjacks would only provide 80% of the amount of iron and 70% of the amount of zinc needed, the Soil Association said.

Education Secretary Charles Clarke recently announced he would review the standard of dinners served in secondary schools. But the Soil Association, said it wanted him to act on primary schools too. Peter Melchett, the group's policy director, said: "It is well known that most school dinners in primary schools do not provide the correct level of nutrients and give children too much fat, sugar and salt. But still Charles Clarke refuses to act to protect children at their most crucial stage of development. If children are encouraged to eat healthily in primary school, they are likely to demand good quality food as they get older." A Department for Education and Skills spokeswoman said work was already under way to improve the quality of school meals. She added: "We are also undertaking a specific monitoring and evaluation exercise on the quality of primary school meals. We are determined to ensure young people are inspired to eat and live healthily." © BBC Health News Thursday 28th October 2004

Bid to cut sudden epilepsy deaths

Guidelines have been issued to try to make unexpected deaths from epilepsy will be a thing of the past. Epilepsy affects more than 300,000 people living in the UK, and official figures suggest about 1,000 die every year as a result of the condition. The National Institute for Clinical Excellence aims to ensure people with epilepsy are being given proper advice to help them manage their condition. It is advising doctors on how best to care for their epileptic patients. A government-funded report in 2002 concluded that more than 40% of deaths from epilepsy were probably avoidable. According to experts, most people with epilepsy can be free of seizures with the right drug treatment. But research suggests up to a quarter of cases are misdiagnosed, meaning patients don't get the treatment they need. The report found failures in the provision of care all through the system. This included problems of timely access to expert specialists and a lack of structured and effective review at primary and secondary care. The report concluded that poor epilepsy management resulted in a substantial number of potentially avoidable deaths. NICE believes its guidance on the diagnosis and management of epilepsy in children and adults should address these issues. Andrea Sutcliffe, executive lead for the guideline, said: "The guideline covers issues of real concern to people with epilepsy, such as accurate and timely diagnosis, appropriate communication and the need for regular reviews of medication." Key recommendations include ensuring precise and early diagnosis, tailored drug therapy and regular structured reviews of care, at least annually, for each patient. It says patients should be actively involved in treatment decisions, something that has not been happening, according to the National Society for Epilepsy. The guideline also emphasises the importance of appropriate advice to women with epilepsy who are of childbearing age. There have been concerns that some epilepsy drugs harm unborn children, but uncontrolled epilepsy can also be damaging. Dr Helen Cross, epilepsy expert at Great Ormond Street Hospital and member of the guideline development group said: "This guideline is comprehensive in both its scope and coverage and will contribute toward the development of an optimal standard of epilepsy care across the NHS." © BBC Health News Wednesday 27th October 2004

Patient tagging 'first in world'

Patients at a Birmingham hospital are to be electronically tagged in a bid to prevent medical mistakes in what has been described as a "world first". Heartlands Hospital is piloting the system which will track the movements of people undergoing surgery through a wireless network. Their records are then brought up on screens for use by staff at key points. Developers believe the system will reduce the risk of human errors and improve medical efficiency.

Digital photographs are taken of patients who are then tagged on arrival and the information is synchronised with their electronic records. David Morgan, a consultant ENT surgeon at the hospital who helped devise the process, said the patients location could then be tracked to within yards and their details fed to visual display units in theatres, anaesthetic rooms and waiting areas. Mr Morgan added he could make changes to the digital operating list while on his rounds using a pocket PC instead of working with typed copies. "This is the only system of its kind in the world," said Mr Morgan. It saves time for doctors because we don't have to go round wards changing typed lists and it enhances security as patients know they are going to have the right operation at the right time and with the right person." He added: "It allows better use of resources so you don't have wasted time in theatre, so it actually saves money in the long term."

The system was developed by Intelligent Medical Microsystems and cost £25,000 to install in one ward and two theatres. © BBC Health News Wednesday 27th October 2004

Cancer services 'need shake-up'

Cancer services in England are disjointed and need to be reformed, according to a parliamentary report. The All-Party Parliamentary Group on Cancer said the new funding system was "exacerbating" the postcode lottery. It claimed GPs were not referring those needing urgent treatment quickly enough and said primary care trusts (PCTs) should not be responsible for funding. It comes as the government announces a national screening programme for bowel cancer, aimed at cutting deaths by 15%.

The first such scheme in Europe, the government would be spending £37.5m on it over the next two years, Health Secretary John Reid told the BBC Breakfast programme. Bowel - or colorectal - cancer is the third most common cancer in men and the second most common in women in the UK. Each year, there are over 18,700 new cases of the disease in men, and over 16,800 cases in women. Dr Reid said thousands of lives would be saved by the screening.

Answering the cross-party report's criticism of cancer funding, Dr Reid said there had been a 12% reduction in the number of cancer deaths since 1997. "We will listen, but I am yet to be persuaded that it is better than what we are doing," he said. The proof of the pudding is in the eating and the results speak for themselves."

The report called for the control of cancer budgets to be handed to the country's 34 cancer networks. The networks are non-statutory alliances between primary care trusts, hospitals, councils and the voluntary sector, which support and plan services on a regional level. It said many of the country's 302 PCTs, which commission health services and have responsibility for spending three quarters of the NHS budget, were "struggling". As a result, it said, there were "worrying implications for the provision of all NHS services but particularly for national priority areas like cancer". The report also recommended GPs go on cancer education programmes to help them recognise which patients need urgent treatment.

Report's main recommendations Strip PCTs of funding powers Hand budgets to cancer network Send GPs on cancer education courses Set up cancer treatment database

Witnesses told the inquiry, which took evidence from the Department of Health, PCTs and patient groups, that PCTs lacked experience - and in many cases expertise - in commissioning cancer services. Ian Gibson, chair of the All Party Parliamentary Group, said: "The inquiry has exposed a serious problem. PCTs are struggling to cope and lack experience in commissioning cancer services. The budget for cancer services must therefore go directly to cancer networks to allow them to plan for sustained improvements in cancer care."

Joanne Rule, chief executive of CancerBACUP, a cancer information charity which co-authored the report, said cancer services needed specialist commissioning. "If not, access to cancer drugs, equipment and services will continue to vary widely from one part of the country to another," she said. Cancer patients deserve more."

The report also suggested data be collected at both national and local levels on the prescribing of cancer treatments recommended by the National Institute for Clinical Excellence. Mayur Lakhani, chair-elect of the Royal College of GPs, denied family doctors were at fault. GPs don't have a problem referring patients for cancer screening - the issue is the availability of scans and tests."

Professor John Toy, medical director at Cancer Research UK, said cancer treatment was improving but that it was unacceptable that quality of care was still being "determined by a person's address". © BBC Health News Wednesday 27th October 2004

Lungs 'best in late afternoon'

Lung function dips and rises on a 24-hour cycle, reaching a peak for most people in late afternoon, researchers have found. Researchers from Long Island Jewish Medical Center say their work suggests this might be the best time of day to take exercise. It might also be the time when respiratory medications are likely to have the most effect. The study was presented at an American College of Chest Physicians meeting.

Many of the body's processes are governed by circadian rhythms which repeat in 24-hour cycles. The new study, which only focused on the hours between 8am and 5pm, suggests that lung function may be controlled by the same pattern. A five-year analysis of 4,835 patients found lung function was at its least effective around midday, rising to a peak between 4pm and 5pm.

Researcher Dr Boris Medarov said: "Circadian rhythms regulate our biological cycles for sleep, activity level, metabolism, and many other processes through our body's exposure to sunlight and darkness. Our study finds that lung function has its own rhythm that may govern how much energy we exert throughout the day and the best times to engage in certain activities. We often associate the end of the work day with being tired and less motivated for physical exertion; however, lung function seems to be at its best during this time. As a result, exercising or engaging in other physical activities in the late afternoon may help us to achieve optimal performance."

Dr Medarov said circadian rhythms of lung function may also have implications for the administration of asthma medications and the timing of medical procedures. Many patients with asthma and chronic obstructive pulmonary disease administer bronchodilators around the clock, when they actually may need less treatments and a different regimen that includes administering the medication at midday when their lung function is at its lowest. It also may be better to extubate (remove tubes) patients in the late afternoon when their lung function is at its best and breathing on their own is easier." Dr Medarov said it might be possible to use relaxation techniques and other types of therapy to modify lung function circadian rhythms.

Dr Mark Britton, chairman of British Lung Foundation, said that it was well known that people with asthma showed signs of a circadian rhythm in their lung function. However, he said they tended to reach a low in the small hours of the morning, and to reach a peak in early afternoon. Dr Britton said it would be advisable to administer preventative medication at a time when the lungs were working most effectively, and this would enable it to penetrate as far as possible into the respiratory tissues. However, he said many people with lung disease often required therapy at the point when their lungs were at their least effective. He said the goal of medication was to try to ensure that any circadian rhythm was flattened out, so the lungs worked steadily all the time. He said this was now much more achievable with the advent of longer-lasting treatments. © BBC Health News Tuesday 26th October 2004

Cancer risk 'encourages sobriety'

A majority of women would be willing to cut their alcohol consumption if they thought it would reduce their risk of breast cancer, research suggests. However, a poll by Breakthrough Breast Cancer found only 7% of women surveyed were aware of any link. Alcohol consumption is known to present a small but significant increase in breast cancer risk. Drinking more than the recommended daily alcohol limit is an increasing trend in women of all ages.

The Office of National Statistics figures show that the trend is most marked in young women aged 16-25. In this group drinking above the recommended limit has more than doubled from 15% in 1988/89 to 33% in 2002/03. The Breakthrough survey found that 12% of women would stop drinking completely, 27% would limit their drinking to one unit a day and 14% would try to reduce their alcohol intake to reduce their breast cancer risk.

Baroness Delyth Morgan, chief executive of Breakthrough Breast Cancer, said: "We don't yet know all the causes of breast cancer but we do know that alcohol, HRT, the contraceptive pill, early periods, late menopause and not having children can all increase risk. Unfortunately, most of the established breast cancer risk factors are things which are outside of our control. However, drinking less alcohol is one of the few things women can do to reduce their risk. It's encouraging that so many women, especially young women, are willing to consider this change."

Dame Gill Oliver, of the charity Macmillan Cancer Relief, said: "It is heartening to hear that young women aged would cut down their drinking to reduce their risk of getting breast cancer in later life. However, a survey by Macmillan Cancer Relief found that one woman in five never checks her breasts for signs of breast cancer and only 42% of women aged 55 and over checked their breasts at least once a month despite being the age group most at risk. I think this shows that the messages are getting through to younger women, but we still have a long way to go in terms of educating older women about breast cancer and how to be breast aware." © BBC Health News Tuesday 26th October 2004

Website on tobacco giant launched

A website has been launched detailing the inner workings of leading tobacco firm British American Tobacco. The site includes 1m pages of memos, research and reports, which BAT was forced to make public by a US court. The researchers compiled the site by scanning documents from BAT's depository in Guildford, Surrey. The website, which will be added to, is a joint project by the London School of Hygiene and Tropical Medicine and the University of California in the US.

The current information relates to company practice from the 1950s to 1995. It contains information on marketing strategies, sports sponsorship, political influence and pricing. When it is completed in 2006 it will contain more than 8m pages of information on the company.

BAT was forced to release the information in 1998 after litigation brought by the State of Minnesota and Minnesota Blue Cross Shield. The project, known as the Guildford Archiving Project, was set up in 2001 as the depository is set to close in 2009. Jeff Collin, a lecturer from the London School of Hygiene and Tropical Medicine, said it was the first time the public would have "real access" to the documents as the Surrey depository had remained largely inaccessible because of limited opening hours and indexing. He claimed: "The website gives us a unique insight into how BAT has prevented the spread of anti-smoking strategies. And this in turn will help the community to develop more effective responses."

In the past, BAT has been accused of obstructing the researchers, who also analysed documents stored at offices in Minnesota in the US - although these are thought not to be as detailed as the papers kept in Surrey. But BAT, which is behind brands such as Lucky Strike, Kent, Dunhill and Pall Mall, said it was not concerned that the website had gone live. A spokeswoman said: "We have known that they have been doing this for some time. Many researchers and journalists have trawled through the documents. If there was anything to be found, it would have been found. There is nothing there that overly concerns us." But she refused to comment on the specific allegation that the company had stopped the spread of anti-smoking strategies across the world, saying BAT was "working with organisations to combat youth smoking".

Brown and Williamson, a subsidiary of BAT, has been accused of lying about the effects of smoking along with other leading tobacco firms in an ongoing $280bn lawsuit in the US. © BBC Health News Tuesday 26th October 2004

Asthma risk 'greater for smokers'

People who smoke are 33% more likely to develop asthma than those who do not, researchers from the Finnish Institute of Occupational Health have said. The team told the European Respiratory Journal the 30-month study of 1,444 people gave the strongest evidence yet that smoking caused asthma.

Smoking has long been thought to aggravate the condition but whether it caused it has been disputed. Anti-smoking groups said the study gave more weight to calls for workplace bans. Cigarette smoke contains over 4,000 substances - many of which irritate the airways.

One of the standing complaints about studies into the effect of smoking is that they usually only cover a fixed population group at certain moments in time. This makes it possible to identify apparent links between smoking and disease - but not to prove that the habit is directly to blame. The Finnish team tackled this problem by only including people in the study who initially showed no signs of asthma or lung disease, and only developed symptoms during the study.

The 521 participants who started to show signs of developing asthma were then monitored over two-and-a-half years, and compared to 923 people with no signs of the allergy. The study found that current smokers were 33% more likely to develop asthma but that people who had given up smoking had an even greater risk - 49% higher than those who never smoked. The risk of asthma was proportional to the number of cigarettes smoked each day - and the total number smoked during a lifetime so far.

However, the finding did not apply to heavy smokers, who smoked more than 15 cigarettes a day, or who had smoked a lot of cigarettes during their life. The researchers believe this finding, which they found surprising, might be explained by heavy smokers giving up or cutting down as soon as they have any breathing problems, before they have had a chance to be diagnosed with asthma. They also stress that individual susceptibility to tobacco damage varies hugely from one person to another. It may be that people who smoke heavily are more tolerant of the irritants in tobacco.

The study also found that female smokers seem to be at a greater risk of developing asthma than their male counterparts. Female smokers and ex-smokers had an increased risk of developing asthma of between 138% and 143%. Lead researcher Dr Ritva Piipari said: "The heavier toll that smoking takes on women could be the result of a greater vulnerability to the ill-effects of smoke. In fact, we have noted that even non-smoking women have an increased risk (57%) of developing a new asthma compared to their male counterparts."

Professor Martyn Partridge, chief medical adviser to Asthma UK, said it had previously been difficult to show that smoking causes asthma as it only needed a few patients with lung disease to be wrongly classified as having asthma to skew the results. He said: "This new study has tried very hard to exclude the previous problems with misdiagnosis, and it does suggest a possibility that smoking may be amongst the numerous lifestyle changes that may have enhanced the risk of adults developing asthma." © BBC Health News Monday 25th October 2004

Stem cells 'could restore vision'

Stem cells taken from the back of the eye could eventually be used to restore normal vision in people with sight problems, researchers have said. Human retinal stem cells regenerated when they were transplanted into the eyes of mice and chicks, scientists at the University of Toronto found. They now plan to see if the same happens in diseased eyes in the hope of eventually treating humans. The findings appear in Proceedings of the National Academy of Sciences.

The retina sits at the back of the eye and is where light rays are turned into images. It acts like the film in a camera to capture images, transform them into electrical signals, and send these signals to the brain. The retina contains millions of cells called photoreceptors (divided into rods and cones), which contain visual pigments. When light strikes these pigments, they briefly lose their colour. This bleaching process triggers nerve impulses, which are transmitted to your brain.

The researchers took retinal stem cells from human cadavers and transplanted them into the eyes of one-day-old mice and chicks. The transplanted cells developed into photoreceptor cells. Lead researcher Brenda Coles said: "When their eyes fully developed, the human cells survived, migrated into the sensory part of the eye and formed the correct cells."

The are now exploring whether the retinal stem cells from these healthy mice will continue to develop when transplanted to mice with diseased eyes. This will help them find out whether retinal stem cells can be used to treat degenerative diseases of the retina such as retinitis pigmentosa and macular degeneration, which are among the most common forms of blindness in developed countries. These diseases affect rods and cones, the photoreceptor cells at the back of the retina, but the nerve cells in front of them usually remain intact.

Ms Coles said: "We're starting with mice to see if they can overcome the genetics involved in disease. The eye itself is telling the stem cells what to do, so when we go to a disease model, it is important to know what those signals from the eye are so we can inhibit them or protect the cells."

Dr Stephen Minger, director of the stem cell biology laboratory at King's College, London, said: "As a first step, I think this paper is superb. Being able to show that they can take a small number of cells from the human eye and expand them to relatively large numbers to implant them and get what appears to be site-specific differentiation into a wide variety of retinal cells is very encouraging." He said it would be important to prove that the implanted cells functioned normally and that they also worked in disease states. Also, it has yet to be determined whether enough of the required number of cells could be generated to repair damage in humans, he said. © BBC Health News Monday 25th October 2004

Cup of tea may help boost memory

Drinking regular cups of tea could help improve your memory, research suggests. A team from Newcastle University found green and black tea inhibit the activity of key enzymes in the brain associated with memory. The researchers hope their findings, published in Phytotherapy Research, may lead to the development of a new treatment for Alzheimer's Disease. They say tea appears to have the same effect as drugs specifically designed to combat the condition.

Alzheimer's disease is associated with a reduced level of a chemical called acetylcholine in the brain. In lab tests, the Newcastle team found that both green and black tea inhibited the activity of the enzyme acetylcholinesterase (AChE), which breaks down this key chemical. They also found both teas inhibited the activity of a second enzyme butyrylcholinesterase (BuChE), which has been discovered in protein deposits found in the brain of patients with Alzheimer's.

Green tea went one step further in that it obstructed the activity of beta-secretase, which plays a role in the production of protein deposits in the brain which are associated with Alzheimer's disease. The scientists also found that it continued to have its inhibitive effect for a week, whereas black tea's enzyme-inhibiting properties lasted for only one day.

There is no cure for Alzheimer's but it is possible to slow the development of the disease. Drugs currently on the market hinder the activity of AChE, and others are being developed which scientists hope will inhibit the activity of BuChE and beta-secretase. However, many of the drugs currently available, such as donepezil, have unpleasant side effects and the medical profession is keen to find alternatives.

The Newcastle University researchers are now seeking funding to carry out further tests on green tea, which they hope will include clinical trials. Their aim is to work towards the development of a medicinal tea which is specifically aimed at Alzheimer's sufferers. The next step is to find out exactly which components of green tea inhibit the activity of the enzymes AChE, BuChE and beta-secretase.

Lead researcher Dr Ed Okello said: "Although there is no cure for Alzheimer's, tea could potentially be another weapon in the armoury which is used to treat this disease and slow down its development. It would be wonderful if our work could help improve the quality of life for millions of sufferers and their carers. Our findings are particularly exciting as tea is already a very popular drink, it is inexpensive, and there do not seem to be any adverse side effects when it is consumed. Still, we expect it will be several years until we are able to produce anything marketable."

Professor Clive Ballard, director of research, Alzheimer's Society, said: "This interesting research builds on previous evidence that suggests that green tea may be beneficial due to anti-oxidant properties. Certainly the effect on the cholinesterase enzyme (the target of current anti-dementia drugs such as Aricept) and beta-secretase (an enzyme which is important in the build up of plaques) is very exciting and requires further investigation."

Black tea - traditional English breakfast tea - is derived from the same plant as green tea, Camellia sinensis, but has a different taste and appearance because it is fermented. © BBC Health News Monday 25th October 2004

Stress 'bad for exam performance'

Pre-exam stress makes it more difficult for candidates to solve complex problems, a US report suggests. Researchers at Ohio State University looked at 19 first year students' performances two days before and a week after a classroom test. They found the ability to deal with complex, open-ended questions improved markedly as stress subsided. However, the students did better at simpler tasks, such as memorising numbers, while under more pressure.

During acute stress the body releases a compound called norepinephrine. Also known as "fight or flight" compound, it allows people to react quickly to an immediate threat. Previous studies have shown it improves some types of mental activity, such as short-term memory. But David Beversdorf, co-author of the report, said: "Even though norepinephrine may help a student recall memorised facts, it could hinder his ability to think flexibly."

For the short-term memory test, students were asked to write down a sequence of nine numbers they had just heard. Another simple test involved thinking of a single word that linked to three others. For example, given "way", "ground" and "weather", they had to add the prefix "fair" to create "fairway", "fairground" and "fair-weather".

For the more complicated problem-solving test, students were shown a grid which contained a series of shapes and symbols. They were asked to choose a shape or symbol which fitted in best with the others. The overall performance here was far better after the classroom exam than before it.

Prof Beversdorf said: "There was a clear relationship between cognitive function and stress levels. The students don't think flexibly right before their exam, typically a time of great stress."

The findings are being presented at the annual Society for Neuroscience conference in San Diego, California. © BBC Health News Monday 25th October 2004

Human tissue use control rejected

Plans to limit the use of tissues taken from living patients have been defeated in the House of Lords. The government believes tissue could be removed and retained without consent in the interest of research, but not for education and training. Opposition peers voted against the latter restrictions in the Human Tissue Bill by 148 votes to 112. But front bencher Lord Warner said the amendments were unacceptable and the government would seek to reverse them.

The Human Tissue Bill was set out to prevent future organ retention scandals such as those seen at Alder Hey Children's Hospital in Liverpool. Liberal Democrat and Conservative peers argued that it would be difficult for medical staff to distinguish between tissue intended for "research" and tissue intended for "education and training" in research methods.

The accepted amendment will mean scientists can assume tissue taken from living patients can be used for research, education or training. Patients who do not want their tissue used in this way will have to make their feelings explicit, or else consent can be presumed. It is estimated that 150 million tissue samples are taken each year during medical operations and procedures. Scientists had previously expressed concern that the Bill could lead to a shortage of tissue, and stymie efforts to develop new ways to tackle disease.

The Bill will still require consent from a patient's will or their family for tissues and whole organs to be removed and retained after they die. Dr Vivian Nathanson from the British Medical Association said: "There's been immense good will in trying to get amendments that would allow proper research, education and training to go ahead because those are essential in treating patients today, and training the staff who will treat patients tomorrow." © BBC Health News Monday 25th October 2004

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