Sunday, 2 October 2011

Plastic surgeons warn over 'stem-cell' breast surgery

Plastic surgeons warn over 'stem-cell' breast surgery

A surgeon performs liposuction The procedure involves grafting fat harvested from the patient by liposuction

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Senior plastic surgeons have issued a warning over a breast enlargement procedure being offered by private UK clinics.

The British Association of Aesthetic Plastic Surgeons (BAAPS) say "stem-cell breast augmentations" are unproven and should not be offered commercially.

The warning came at the group's annual conference in Birmingham.

One Harley Street clinic offering the surgery responded by saying they were "confident" the treatment was safe.

Research 'hijacked'

The surgery involves using fat harvested from the patient's stomach or thighs via liposuction and using it to build up the breast.

Prior to transplantation, around half of of the fat is processed to enrich the stem-cell content - naturally occurring regenerative cells found within the fat.

The hope is that this enrichment process can improve the prospects for the fat graft.

The same technology is being used in reconstructive surgery where "cell-enriched fat grafting" is now being offered in several centres around the world to reconstruct breasts following cancer surgery.

Trials are currently under way at NHS centres in London, Glasgow, Swansea, Norwich and North Tyneside.

But BAAPS believes more clinical testing needs to be done to establish its safety before it is used commercially on healthy women.

Start Quote

We have to make sure whatever treatment we offer for breast augmentation is safe in the long-term”

End Quote Eva Weiler-Mithoff Consultant plastic surgeon

"To think that this unproven research is hijacked and used in the commercial sector is really an appalling thought," former BAAPS president and consultant plastic surgeon Adam Searle told the BBC. "Not least when it's being utilised by inadequately trained practitioners."

Private London clinics, The Harley Street Skin Clinic and The Private Clinic of Harley Street, have been advertising stem-cell breast augmentations for some time. The latter says they will have treated some 200 patients by the end of this year.

In a statement, Dr Valentina Petrone of the The Private Clinic, said the views of BAAPS were welcome, but insisted the surgery was safe and every precaution was taken.

"The Private Clinic, is confident in respect to the safety of this treatment. Furthermore ongoing studies reassures us even more. We have strict patient selection criteria and clinical protocols in place.

"We, of course, look forward to completion of studies and any other findings as they become available over time and will, if necessary, adapt our protocols accordingly."

Cancer concern

The BAAPS warning came the same week new clinical data on cell-enriched fat grafting was presented to an conference in Nottingham.

Eva Weiler-Mithoff, a consultant surgeon at Canniesburn Plastic Surgery Unit in Glasgow, presented details of a 12-month trial to a meeting of the Oncoplastic Reconstructive Breast Surgery group.

The trial involved around 70 patients in seven centres in four countries. The data is yet to undergo peer review and was sponsored by Cytori Therapeutics, the US makers of a machine which can enrich the fat.

Consultant plastic surgeon Eva Weiler-Mithoff discusses the findings of a 12-month clinical trial

Ms Weiler-Mithoff told the BBC the procedure appears to be effective in cancer patients in filling in defects in the breast and in improving the appearance and feel of the breast. Nor were there any serious side-effects or recurrence of breast cancer to date.

"Traditional fat-grafting (in breast reconstructive surgery) does not work terribly well because there is not enough circulation to support the survival of the fat graft," she said.

"We know if we augment the fat graft with the naturally occurring regenerative cells in fat tissues we can improve the circulation around the fat graft and the survival of the fat graft."

But she said longer-term results were needed - at least five to10 years of data - before the technique could be deemed safe for use in cosmetic surgery.

"We still don't have enough long-term outcome data to say it's safe in the sense that it doesn't encourage the cancer to come back or new breast cancer to develop," she said.

"Because breast cancer is such a common disease we have to make sure whatever treatment we offer for breast augmentation is safe in the long-term."

A previous Japanese study involving 40 Japanese women undergoing cosmetic stem-cell breast augmentation also deemed the procedure to be effective, but also called for additional study.

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First 250 Southern Cross homes transferred

First 250 Southern Cross homes transferred

Southern Cross sign Southern Cross is to be wound up by the end of the year

A third of Southern Cross care homes have been transferred to new operators, the company has announced.

Southern Cross said the transfer of 250 homes would be followed by further transfers in October and November.

Southern Cross was the UK's biggest care home operator, with 752 homes, but ran into difficulties when it was unable to pay its rent to landlords.

In July, the firm said it was to cease trading after all of its landlords said they wanted to leave the group.

The first "wave" of homes have been transferred to about 18 different operators.

Its largest landlord, NHP, which owns 249 of the homes, will be included in the second wave.

NHP is forming a new company, HC-One, with turnaround specialists Court Cavendish to run the homes itself.

HC-One is headed by the former boss of the Priory chain of clinics, Dr Chai Patel.

Winding up

Southern Cross said it had entered unconditional business purchase agreements covering 70% of its homes, with the remaining 30% still in progress.

It said all the homes would be transferred by the end of the year and the company would be wound up.

The firm has said that landlords are committed to providing continuity of care to its 31,000 residents, and that residents should notice no changes on a day-to-day basis.

It maintains that no homes will close and says the "vast majority" of its 43,000 staff will have their jobs protected, with care home workers transferring to the new operators.

The 200 Darlington-based back office workers will transfer to HC-One.

The company also announced the resignation of it chairman, Christopher Fisher, who stepped into the role in April to oversee the restructuring process.

"Now that the transfer of homes has commenced, I consider my role complete," Mr Fisher said.

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Leek and potato soil linked to E. coli outbreak

Leek and potato soil linked to E. coli outbreak

Richard Westcott reports on the findings

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Soil stuck on leeks and potatoes may have been the source of an E. coli outbreak in the UK earlier this year, according to the Health Protection Agency (HPA).

There were 250 cases scattered across England, Wales and Scotland between December 2010 and July 2011.

The Food Standards Agency said it was a "myth" that dirt did no harm.

The HPA stressed that the vegetables were safe to eat, but reminded people to ensure their food was washed.

Most of the cases were mild, but 74 people needed to go to hospital and one patient, who had underlying health problems, died.

Details of the outbreak were reported weekly to health professionals, but have only just been publicised to the general public.

A spokesperson said: "At the outset it was not clear what was causing the outbreak and we had no information that would have enabled the public to take any steps to protect themselves."

The disease was caused by a rare strain of E. coli called O157 PT8 which is different from the strain that caused the widespread outbreak in Germany.

'Timely reminder'

Infected people were 40 times more likely to have been in a household where loose leeks were handled and 12 times more likely to have been in a household which bought sacked potatoes than people who stayed infection-free.

Dr Bob Adak, head of the HPA's outbreak control team, said: "The vegetables could have carried traces of contaminated soil.

"It is possible people caught the infection from cross-contamination in storage, inadequate washing of loose vegetables, insufficient hand washing after handling the vegetables or by failing to thoroughly clean kitchen equipment, utensils or surfaces after preparing the vegetables."

Dr Andrew Wadge, chief scientist at the Food Standards Agency, said: "It's sadly a myth that a little bit of dirt doesn't do you any harm.

"Soil can sometimes carry harmful bacteria and, although food producers have good systems in place to clean vegetables, the risk can never be entirely eliminated.

"This outbreak is a timely reminder that it is essential to wash all fruits and vegetables, including salad, before you eat them."

Leek and potato soil linked to E. coli outbreak

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Tuesday, 27 September 2011

Vending machines 'undermine' hospitals' good work'

Vending machines 'undermine' hospitals' good work'

Chocolate in a vending machine Vending machines tend to dispense high-calorie food like chocolate

Hospitals are, by definition, buildings that are dedicated to health.

But in this week's Scrubbing Up, Dr Rachel Thompson, deputy head of science at World Cancer Research Fund, says that good work is being undermined by the contents of hospital vending machines.

Whenever I visit hospitals, I am always struck by how the efforts of the dedicated healthcare professionals who work in them are being undermined by what is happening in the waiting areas.

All too often, these waiting areas have vending machines that are filled with high-calorie foods and drinks such as chocolate bars, crisps and sugary drinks.

But because these foods are a cause of obesity, they are part of the reason many of the people will have ended up in hospital in the first place.

There is strong scientific evidence that excess body fat is a risk factor for cancer, as well as other non-communicable diseases such as heart disease and diabetes.

And yet hospital vending machines are selling products that are a cause of obesity at the same time as the health professionals working there are trying to cope with its consequences.

That is why hospitals should put an end to vending machines that sell high calorie foods and drinks.

Little focus

It is true that on its own this would be unlikely to have a serious impact on obesity levels.

You would have to spend a lot of time in hospital waiting rooms for the contents of the vending machines to make much of a difference to your weight.

Start Quote

There is no great mystery about what needs to happen”

End Quote

But rather, the fact that hospital vending machines are filled with these kinds of foods and drinks is a symptom of how little meaningful focus there is on the obesity crisis.

Across society, big changes are needed if we are to address obesity and the preventable cases of cancer and other diseases that result from it.

The changes that we need are supported by common sense.

If you prioritise the needs of motorised transport when you plan a town, it is to be expected that people won't walk or cycle enough.

If you allow the food and drinks industry to market unhealthy products to children, then don't be surprised when children pester their parents to buy those products.

But the fact that hospital vending machines are still stocked with high-calorie foods and drinks illustrates that we are not recognising the problem.

There is no great mystery about what needs to happen.

There is already a large evidence base for what works and doesn't work when it comes to policy changes. What we need to see is political will and a change to the mindset where we tolerate the things that promote obesity.

This would not only mean the end of the kind of culture where the sale of unhealthy foods and drinks in hospital waiting rooms is seen as acceptable.

It could also mean fewer people end up in those waiting rooms in the first place.

Friday, 23 September 2011

mengele: abo's malaise

mengele: abo's malaise

cjd deaths up year on year !

CJD Statistics


CJD Figures

These figures show the number of suspect cases referred to the NCJDRSU in Edinburgh, and the number of deaths of definite and probable cases in the UK, from 1 January 1990 up to 5th September 2011

REFERRALS OF SUSPECT CJD

DEATHS OF DEFINITE AND PROBABLE CJD

Year

Referrals

Year

Sporadic

Iatrogenic

Familial

GSS

vCJD

Total Deaths

1990

[53]

1990

28

5

0

0

-

33

1991

75

1991

32

1

3

0

-

36

1992

96

1992

45

2

5

1

-

53

1993

79

1993

36

4

5

2

-

47

1994

119

1994

54

1

5

3

-

63

1995

87

1995

35

4

2

3

3

47

1996

133

1996

40

4

2

4

10

60

1997

163

1997

60

6

4

2

10

82

1998

155

1998

64

3

3

2

18

90

1999

170

1999

62

6

2

0

15

85

2000

178

2000

50

1

2

1

28

82

2001

179

2001

58

4

4

2

20

88

2002

163

2002

72

0

4

1

17

94

2003

162

2003

79

5

4

2

18

108

2004

114

2004

50

2

4

2

9

67

2005124200567485589
2006112200669163584

2007

119200764291581

2008

150200888523199
2009153200978235391
2010149201084361397
2011*108201149261260

Total Referrals

2841

Total Deaths

1264

67

89

44

172

1636

*As at 5th September 2011

Summary of vCJD cases

Deaths

Deaths from definite vCJD (confirmed):

Deaths from probable vCJD (without neuropathological confirmation):

Number of deaths from definite or probable vCJD:

119

53

172

Alive

Number of definite/probable vCJD cases still alive:

3

Total number of definite or probable vCJD cases (dead and alive):

175

(Table updated 9th September 2011)

The National Creutzfeldt-Jakob Disease Research & Surveillance Unit (NCJDRSU)


The incidence of Creutzfeldt-Jakob disease (CJD) is monitored in the UK by the National CJD Research & Surveillance Unit (NCJDRSU) based at the Western General Hospital in Edinburgh, Scotland. The Unit brings together a team of clinical neurologists, neuropathologists and scientists specialising in the investigation of this disease. This document is intended to summarise the research in progress at the NCJDRSU and also provide some background information about CJD and other human spongiform encephalopathies. We have also provided some links to other resources and contrary points of view available on the Web.


Creutzfeldt-Jakob Disease Surveillance.

  • Figures for the number of CJD cases and referrals of suspected cases of CJD to the NCJDRSU since 1990.
  • NCJDRSU protocol for CJD surveillance across the UK.
  • National Referral System. From July 2004, a new national reporting system was announced by the Chief Medical Officer. This is centred on the National CJD Reporting Form to be faxed, by the notifying clinician, to the National Creutzfeldt-Jakob Disease Research & Surveillance Unit (NCJDRSU), the National Prion Clinic (NPC) and the local CCDC.
  • Interim guidance on incidents involving inherited prion disease - this document sets out how inherited prion disease incidents should be reported to the CJD Incidents Panel and complements the guidance on local reporting by clinicians of CJD cases to public health departments (above).
  • Text and figures of the latest annual report of the NCJDRSU covering the period 1990-2009 (published 11th March 2011).
  • Archive of previous NCJDRSU annual reports (1992-2008).
  • National CJD Research & Surveillance Unit Scientific Report 2007/08 (published 13th November 2008).
  • Reporting CJD cases to public health departments - Guidance Document. - (updated November 2006)
  • Potential treatments for Creutzfeldt-Jakob disease (updated July 2006).

Information on variant CJD.

  • Reproduction of the complete Lancet article published by the NCJDRSU in April 1996.
  • Text of a letter written by Dr Robert Will to every Neurologist in the UK. This letter describes in some detail the clinical and pathological variants observed between sporadic CJD and the new variant of the disease which has been identified here at the NCJDRSU.
  • The original statement issued by SEAC, the government's advisory committee on spongiform encephalopathies, about these ten cases of the new variant of CJD.
  • Protocol for the investigation of geographically associated cases of variant CJD
  • Incidence of variant Creutzfeldt-Jakob disease diagnoses and deaths in the UK compiled by N J Andrews at the Statistics Unit, Centre for Infections, Health Protection Agency.(updated 18th May 2011)
  • Figures for the number of vCJD cases worldwide [data courtesy of the European and Allied Countries Study Group of CJD (EUROCJD/NEUROCJD)]

Care and Support.


Practical information about CJD.


Creutzfeldt-Jakob Disease research.

    .....SECTION UNDER DEVELOPMENT .........

  • Complete reference list of scientific research articles produced by the NCJDRSU since 1990.

Other links


About ourselves

  • The people involved in the research being undertaken at the CJD unit.
  • The setup, details of the funding of the CJD and the collaborative projects we are involved in.
  • Our address should you wish further contact.

For enquiries contact:

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