Document Directory

21 Dec 00 - Medicine - Vaccine brings hope of cure for Alzheimer's
21 Dec 00 - Medicine - Missile radar fights breast cancer
21 Dec 00 - Medicine - Vaccine may cure Alzheimer's disease
21 Dec 00 - Medicine - Scientists close to finding a vaccine for dementia
20 Dec 00 - Medicine - Coffee alert for pregnant women
20 Dec 00 - Medicine - Pregnancy fear on epilepsy drugs
19 Dec 00 - Medicine - MPs vote to allow cloning of human embryos
19 Dec 00 - Medicine - Why life begins to get confusing at 40
18 Dec 00 - Medicine - Scientists want free access to genome data
18 Dec 00 - Medicine - Scientist blocks access to human genome results
17 Dec 00 - Medicine - Patient is given pig's blood
17 Dec 00 - Medicine - Schools may test for heart disease
17 Dec 00 - Medicine - Doctors want right to send patients abroad
15 Dec 00 - Medicine - Fruit flies reveal Holy Grail of long life
15 Dec 00 - Medicine - Doctors doubt value of breast cancer tests
14 Dec 00 - Medicine - Scientists find insect gene that may hold clues to human ageing
13 Dec 00 - Medicine - Bladder cancer linked to smoking
13 Dec 00 - Medicine - New limits for stem cell research
12 Dec 00 - Medicine -Cannabis can halt 'fertility signals'
12 Dec 00 - Medicine -Flyers with blood clots sue airlines
12 Dec 00 - Medicine - Sugar gel breast implants banned
12 Dec 00 - Medicine - Row on age limit for the morning after Pill
12 Dec 00 - Medicine - 'Unsafe' hydrogel breast implant is withdrawn from sale
11 Dec 00 - Medicine - GPs rebel against flu drug advice
11 Dec 00 - Medicine - Breakthrough as scientists find way to make cannabis soluble
11 Dec 00 - Medicine - Chinese doctors say herbal cures can combat Aids
11 Dec 00 - Medicine - Medical experts are alarmed by rise in fraudulent research
11 Dec 00 - Medicine - New tests to identify unhealthy embryos
11 Dec 00 - Medicine - Alzheimer drugs 'may be harmful'
11 Dec 00 - Medicine - Morning-after pill for sale at 20 in New Year

21 Dec 00 - Medicine - Vaccine brings hope of cure for Alzheimer's

By David Derbyshire, Science Correspondent

Telegraph... Thursday 21 December 2000

A new vaccine for Alzheimer's disease has been found to prevent memory loss and mental problems, bringing hope to Britain's 600,000 sufferers.

In a series of animal experiments, researchers found that the treatment prevents the build-up of damaging protein deposits in the brain and protects against symptoms of dementia. Clinical trials of the vaccine are likely to begin in America next year. Alzheimer's charities yesterday described the results as "extremely exciting" and said that they held the promise of the first cure for the disease.

Alzheimer's is thought to occur when toxic compounds known as beta-amyloid peptides build up in the brain, forming insoluble deposits that damage nerve cells. Previous studies on a vaccine developed by the drugs company Elan have shown that injecting mice with beta-amyloid peptide provokes an immune response and prevents the formation of these amyloid plaques. The new research, published in two papers in today's Nature magazine, takes that research further.

Using genetically engineered mice created to mimic the onset of the disease, researchers from the University of Toronto and the University of Florida showed that immunisation with amyloid peptides prevents learning impairment. Dr Peter St George-Hyslop, a Toronto neurologist, said: "Not only were we able to clean up the brain tissue, we also prevented the behavioural consequences of Alzheimer's. Obviously it is more important that a treatment or prevention in humans is able to block the clinical dementia."

The scientists believe that the study provides proof that while other factors play a role in the disease, Alzheimer's is initiated by amyloid peptides. Both teams used an elaborate water-maze test devised by Prof Richard Morris, a neuroscientist at the University of Edinburgh.

21 Dec 00 - Medicine - Missile radar fights breast cancer


PA News... Thursday 21 December 2000

A missile radar system has been tweaked so it can be used to treat breast cancer in the US.

Around 100 volunteers will have their breasts blasted with focused microwaves which heat the cancer cells to about 115 degrees Fahrenheit to kill them.

The technique was originally developed by a weapons team at the Massachusetts Institute of Technology.

Alan Fenn, a senior member of the team, explained: "As the Cold War was ending and we were asked to look for alternative applications, I discovered that this same focused microwave technology for missile detection could, in theory, be used to treat cancer cells."

21 Dec 00 - Medicine - Vaccine may cure Alzheimer's disease

James Meek, science correspondent

Guardian... Thursday 21 December 2000

An experimental vaccine against Alzheimer's disease, the devastating brain illness which affects some 600,000 Britons, appears to restore memory and reasoning power, according to new research.

The vaccine is undergoing safety trials in human volunteers in Britain and the US and is due to be tested on Alzheimer's sufferers next year .

Two tests in mice that were genetically modified to reproduce some of the symptoms of Alzheimer's already suggest it can halt the dementia.

Previously, the vaccine had been shown to clear microscopic clumps, or plaques, of a protein called beta amyloid - thought to be at the centre of the Alzheimer's chain of cause and effect - from the brains of the transgenic mice.

In a series of articles published today in the journal Nature, researchers in Toronto and Florida, using tests developed by neuroscientists at Edinburgh University, reveal that the vaccine not only clears plaques but protects the mice from further mental decline.

The vaccine, developed by a Californian subsidiary of the Irish firm Elan Pharmaceuticals, has created a buzz in the Alzheimer's research community because the science behind it is unexpected.

"Almost everybody who believes this story - as I do now - started out very sceptical," said Paul Chapman, professor of neuroscience at Cardiff University.

Traditionally vaccines have been used to train the body's immune systems to recognise and destroy viruses before the patient is infected. But Alzheimer's is not thought to be viral, and in trials the vaccine will be administered to people who already have the disease.

Elan's vaccine is a version of the beta amyloid protein itself. Its apparent effectiveness relies on the fact that the brain and the body have separate immune systems. By introducing high doses of the vaccine into the body, the immune system seems to produce enough antibodies for some to migrate into the brain and begin attacking beta amyloid there, where it is doing damage.

The key to the new vaccine experiments in Canada and the US was a complex test of short and long-term memory in mice, devised by Professor Richard Morris and his team at Edinburgh University.

But researchers caution that even if trials go well, it could be five years before a vaccine reaches patients. There are also several caveats: the dissimilarity of humans and mice and that any vaccine may attack benign body chemicals.

Sceptics point out that another rogue protein, not replicated in the GM mice, is associated with Alzheimer's. But optimists argue that there is growing evidence beta amyloid is the key and other means of destroying it, like drugs, could be also be used.

All three research groups used Elan's patent brand of Alzheimer's mouse, modified to carry a human gene which produces the problem protein. Prof Chapman said Elan would gain scientific credibility if it made its mouse more widely available so other labs could replicate the experiments.

But Prof Morris said: "From my point of view, If I'm embarking on experiments taking two years, I don't want Elan to be giving animals to another lab behind my back."

21 Dec 00 - Medicine - Scientists close to finding a vaccine for dementia

By Steve Connor, Science Editor

Independent... Thursday 21 December 2000

A vaccine against Alzheimer's disease could soon a be reality after pioneering research showed that the long-term mental decline associated with the disease can be prevented.

Three independent teams of scientists have demonstrated in animal experiments that a vaccine can prevent the build-up of protein deposits in the brain which are believed to cause Alzheimer's.

Scientists have shown that it is possible to arrest the decline in the mental performance of laboratory mice that would otherwise be destined to develop similar symptoms to those of the human disorder. The scientists behind the research, which is published today in the journal Nature, believe the findings could be developed into an effective treatment for a disease that affects one in 20 people over the age of 65, and a third of those over 80.

Alzheimer's disease, which is sometimes unkindly called the "living death," is a seriously debilitating condition which is of growing concern for a country with a rapidly ageing population.

Peter St George-Hyslop, the director of the Centre for Neurodegenerative Diseases at the University of Toronto, where one of the three studies took place, said the findings were unequivocal. "Not only were we able to clean up the brain tissue, but we also prevented the behavioural consequences of Alzheimer's. Obviously, it is more important that a treatment or prevention in humans be able to block the clinical dementia," Dr St George-Hyslop said.

The vaccine was developed from a small protein, or peptide, that builds up in the brain of Alzheimer's patients to produce the tell-tale deposits or "plaques" that were thought to cause dementia.

Vaccinated mice had fewer plaques and were much better than unvaccinated animals at performing and remembering how to find an underwater platform when swimming in an enclosed tank - a classic test of mental ability in mice.

The other two studies which led to a similar conclusion came from a team led by scientists at Edinburgh University and a group led by the University of South Florida in Tampa.

Harry Clayton, chief executive of the Alzheimer's Society, said: "If the results of this study can be replicated in humans it means the serious possibility of an intervention that could treat or even prevent dementia developing.

"It really is a great step forward in our knowledge."

20 Dec 00 - Medicine - Coffee alert for pregnant women

By David Derbyshire, Science Correspondent

Telegraph... Wednesday 20 December 2000

Women who drink more than four cups of strong coffee a day may be twice as likely to have a miscarriage, a new study suggests.

Swedish researchers say they have found a link between high caffeine intake and early termination of pregnancy. However, British scientists said last night that the study was not conclusive and urged women not to panic.

The findings, due to be published in the New England Journal of Medicine, come from a study of 562 Swedish women who miscarried by the 12th week. Prof Sven Cnattingius, of the Karolinska Institute, Stockholm, says: "We found that women who drank more than four cups of coffee per day had double the increase of spontaneous abortions." Those who drank two to three cups increased their risk of miscarriage by 30 to 40 per cent.

A spokesman for the Oxfordshire-based Coffee Science Information Centre, said women should not panic. "The Centre for Pregnancy Nutrition advises that it is safe for women to consume 240-300mg of caffeine if pregnant or breast feeding. A cup of instant coffee contains 60mg, which means five cups are within recommended limits." The spokesman added that the study had demonstrated an association and not a cause and effect between caffeine and miscarriages.

A Department of Health spokesman said: "This sounds like an interesting piece of research that we will look into. But at the moment we will have to wait to see full results of the survey before we give any advice to pregnant women."

20 Dec 00 - Medicine - Pregnancy fear on epilepsy drugs

Sarah Boseley, health editor

Guardian... Wednesday 20 December 2000

Women who take one of the commonest medications for epilepsy while they are pregnant are at risk of having a child with impaired brain development, according to research published today.

There have been concerns for some time that epilepsy drugs could harm the foetus, but scientists have found it difficult to assess whether any damage is caused by the medication, the disease itself or other factors.

A study of 721 women with epilepsy carried out by researchers at the university department of neurology in Liverpool has now pointed the finger at the drug valproate which has been prescribed in the UK for 25 years.

Writing in the Journal of Neurology, Neurosurgery and Psychiatry, David Chadwick and colleagues said their findings suggest use of the drug in pregnancy "carries particular risks for the development of children exposed in utero".

The findings have serious implications for women with epilepsy of childbearing age, who make up a third of all those taking anti-epileptic medicines. One in 250 pregnant women is estimated to be on anti-epilepsy medication.

Hardly any of the 721 women who took part in a survey had changed the epilepsy drugs they were on during pregnancy, indicating that neither they nor their GPs were aware that their baby may be at risk of impaired brain development.

The scientists asked the women, who were all registered with the Mersey regional epilepsy clinic, about their medication and about the educational development of their children.

Children whose mothers had taken anti-epilepsy drugs while pregnant were 50% more likely than others to have additional educational needs, including extra help in mainstream schools or attendance at a special school.

The numbers were particularly significant among women who had taken valproate alone. Their children had a threefold increased risk of additional needs. Those who had taken a combination which included valproate had over twice the risk.

The authors point out that over 90% of pregnancies among women with epilepsy are problem free. They also say that their findings must be viewed with caution because of the retrospective nature of the study.

Yet they are clear that "women are at increased risk of adverse outcomes".

They are undertaking further research to establish the effects of current medication on pregnant epileptics, but they also want to see more work done on new drugs arriving on the market.

19 Dec 00 - Medicine - MPs vote to allow cloning of human embryos

By Philip Webster And Greg Hurst

Times... Tuesday 19 December 2000

Controversial research involving the cloning of human embryos was backed by MPs after an impassioned Commons debate last night.

After a rare free vote MPs supported an amendment to the Human Fertilisation and Embryo Act by 366 votes to 174. It could pave the way to finding a cure for chronic degenerative diseases such as Parkinson's and Alzheimer's.

The decision came after Yvette Cooper, the Public Health Minister, appealed for scientists to be given the go-ahead for stem cell research, denying that it was a "slippery slope" to human cloning. The vote came in the face of fierce opposition from "pro-life" campaigners.

Ms Cooper told the Commons that the research could hold the key to healing within the human body, giving hope not only to those suffering from degenerative diseases but also cancer and heart disease victims. "There are immense potential benefits from allowing this research to go ahead, particularly for those suffering from dreadful chronic disease."

She said there were strong reasons to back the regulations, which were a "sensible extension" of the existing law and would be subject to a strict regulatory framework and limited to embryos up to 14 days old.

Strongly denying that the move could lead to human reproductive cloning, Ms Cooper insisted: "Parliament is not being asked to cross the Rubicon today. Human reproductive cloning is illegal and must stay illegal. Under these regulations it will stay illegal. The idea of cloning babies is completely unacceptable to the House and public opinion as well."

In a well-attended session the debate cut across traditional party lines. Although most Labour MPs strongly supported the change, 73 did not. Some Conservatives backed the research.

Liam Fox, the Shadow Health Secretary, voiced his personal opposition to the use of embryo cells, saying he was not convinced there was no alternative. Dr Fox, a former general practitioner, said: "The benefits of the medical revolution are immense from limb grafts and transplantation to the elimination of diseases. But the medical revolution carries with it moral, ethical and philosophical consequences and our ability to deal with these matters sometimes lags behind our technical knowledge.

"Just because we can do something does not mean we have to. We need to establish a clear framework within which to operate." He said that the rules should have been introduced in a new Bill rather than in amendments to existing legislation.

19 Dec 00 - Medicine - Why life begins to get confusing at 40

Reports by Cahal Milmo

Independent... Tuesday 19 December 2000

Researchers dealt a blow to the notion that life starts at 40 yesterday by declaring that the middle-aged suffer a sharp decline in brain power.

A study of more than 2,000 volunteers from 18 to 87 found the over-40s found it more difficult to perform simple tasks such as remembering numbers or recognising faces.

Between the ages of 40 and 50, brain power is reduced by 15 per cent compared to the age of 20, with a further slip of 17 per cent before the age of 70, the British Psychological Society meeting was told.

Professor Keith Wesnes, who runs a research company in Reading that did the study, said: "We clearly get worse with age. We remember less clearly than we used to and also it seems to take longer to make decisions. We don't concentrate as well or recognise things as quickly. People have traditionally linked this sort of thing with being in your 70s or 80s but we have found it is happening in your 40s and 50s.''

The study used a computer programme to test the reaction times and of volunteers to words, pictures and numbers.

The decline is thought to be caused by the wasting of neuro transmitters, proteins that dictate the speed with which the brain can carry out tasks. But Professor Wesnes gave some reassurance. "We are not talking about a complete loss of the ability to recognise a face, just that it will take quite a bit longer."

18 Dec 00 - Medicine - Scientists want free access to genome data

By Mark Henderson, Science Correspondent

Times... Monday 18 December 2000

The head of an American genetics company has angered scientists from the public Human Genome Project by striking a deal that allows him to exploit his research without sharing it.

Craig Venter, the head of Celera, agreed in June to publish with the project a rough draft of the genome, a complete list of the genetic code of a human being.

Dr Venter now plans to publish his work in Science journal. Other genetic researchers believe that this amounts to "free advertising" for Celera and sets a precedent on access to research data that could hold back genome work.

Critics accuse the magazine of pandering to Dr Venter's ambition, giving his commercial work the "fig leaf" of academic respectability that it needs if the scientist is ever to win a Nobel Prize. Some have pointed out that Celera is a corporate donor to Science's publishers.

In protest, the public genome consortium, which includes British scientists at the Sanger Centre and the European Bioinformatics Institute (EBI) near Cambridge, is to publish its findings in the British-based Nature journal, a rival to Science. Both papers are expected to be published in February.

Scientists who publish their work in either journal must normally submit detailed information about their experiments to one of three international databases, so that independent researchers can verify their conclusions and use their findings to assist their own studies. In Celera's case, however, Science has agreed that the company can keep the complete data on its own website instead.

Researchers will be allowed access to limited information free of charge, but commercial users will have to pay for it, and anyone wanting more than a fraction of the data must sign a detailed legal agreement first.

Ewan Birney, team leader in genomic annotation at the EBI, said that the deal would undermine the principle of unfettered access to basic research that normally underpins the scientific publication process. "This overturns all the precedents for data release in this field," he said.

"If we don't have access to all the data, rather than small chunks, we simply cannot do research into whole genomes rather than single genes.

Dr Birney has written an open letter with Professor Sean Eddy of the US Howard Hughes Medical Institute, urging researchers to protest to Donald Kennedy, the editor-in-chief of Science.

Michael Ashburner, Professor of Biology at Cambridge University and joint head of the EBI, said that the publication terms threatened the future of genomics research.

Professor Ashburner said that he and Dr Birney did not object to the principle that Celera, which paid for its research itself, should be allowed to set its own access terms and sell its data. The company, however, ought not to seek academic publication unless it agrees to full disclosure .

18 Dec 00 - Medicine - Scientist blocks access to human genome results

By Charles Arthur, Technology Editor

Independent... Monday 18 December 2000

Craig Venter, the gene researcher who angered many scientists by turning the unravelling of the human DNA sequence into a commercial race, has raised their ire again by declaring he will not make his results public.

Celera Genomics, the company set up by Dr Venter, has announced it will allow access to its database containing the entire human DNA sequence to only those scientists who promise they will not use it for commercial ends - a requirement that will put off many potential users. Celera also says it will not release its data to the publicly funded GenBank , which allows free access to anyone. The move has raised fears that scientific research will be held back.

"Someone else being able to reproduce your experiment is part of the scientific process," said John McPherson, co-director of the Genome Sequencing Center at Washington University in St Louis, Missouri. "People take it and expand on it, and that drives science. This is a departure from that."

Celera and the Wellcome Trust Sanger Centre in Hinxton, Cambridge, announced in June they had completed a "first draft" of the 3 billion "letters" of DNA code that make up a typical person's genetic blueprint. But a huge amount of work remains before it is turned into a useful collection that weeds out the stretches with no apparent function from the potentially valuable genes affecting the body.

In the past, companies that have sequenced stretches of the human genome have put the results into GenBank.

Celera, where Dr Venter is chief executive, sees it differently. "This is something that we discussed with GenBank over a fairly lengthy period," said Paul Gilman, director of policy planning at Celera, based in Maryland. He said Celera needed protection from commercial competitors.Celera finally decided GenBank could not meet its requirements, and would instead keep its database - which contains annotated descriptions of the entire sequence, pointing to what it believes are the useful areas - only for access by non-commercial staff. That would preclude searches for particular genes which might cause a disease, unless the scientist performing it was willing in effect to turn the results over to Celera - which could then exploit it commercially by patenting the gene sequence and drugs that "target" that gene (or the protein for which it codes) to treat the disease.

Science magazine is expected to publish Celera's results in mid-February, while the Hinxton work will be published in Nature, a rival journal. Douglas Kennedy, editor-in-chief of Science, said there would be no race to publish, but agreed that because the two magazines were published on different days - Nature on Thursday and Science on Friday - some conflict was almost inevitable. There is a possibility the papers will publish at the same time to avoid ruffled feathers.

Mr Gilman said he was aware Science had been pressured to disallow Celera's paper because of the restrictions the company wanted to put on the database access.

17 Dec 00 - Medicine - Patient is given pig's blood

Lois Rogers, Medical Correspondent

Sunday Times... Sunday 17 December 2000

A heart surgeon has transfused pig blood into a human patient in an operation that could have far-reaching consequences for animal-to-human transplants.

Dhaniram Baruah, a fellow of the Royal College of Surgeons, put more than half a pint of the blood into a man suffering from severe anaemia.

Baruah, 50, from the north Indian state of Assam, was in talks at the Department of Health last week, in the hope of continuing his work in Britain.

He claims he has developed a method of preventing the rejection of animal tissue by the human body and wants to canvass support for his programme to establish xenotransplantation - the use of animal donors in human medicine.

Hussan Ali, 22, a labourer, agreed to receive the pig blood last month as a last effort to gain a new lease of life.

Almost four weeks on, Ali is still alive and has been discharged from hospital. Test results confirm Ali has "non-human" blood cells circulating in his body. Further DNA analysis is under way to establish the animal origins of the cells.

Baruah believes he is on the way to a medical breakthrough that will provide a plentiful supply of blood for surgical procedures in the developing world, where human blood donors are in short supply.

Pig blood, he believes, could be used to treat Aids patients, haemophiliacs and sufferers from other blood disorders.

"There is no demand for this sort of treatment in England because you do not have a problem collecting human blood, but I believe I can use the same technique to make donor bone marrow cells compatible from unmatched donors," he said. "It will be of great value in treating leukaemia patients."

Baruah, who has worked as a cardiac surgeon at Glasgow Royal Infirmary and the Karolinska Institute in Sweden, believes the experiment taught him valuable lessons in how to develop xenotransplantation, using an unidentified compound to prevent rejection.

So far he has refused to reveal details of this so-called antigen suppression agent, used to treat the animal donor organs and blood, because he is planning to patent his discovery. The agent is necessary to prevent the body from rejecting tissue from another organism.

The claims have been greeted with sceptical curiosity at the Department of Health, where Baruah was met by Martin Houghton, secretary of the UK Xenotransplantation Interim Regulatory Authority, (UKXIRA) and John Dark, director of the heart transplant unit at the Freeman hospital, Newcastle upon Tyne.

Dark declined to comment, but the department said: "We do not believe the participation of human patients in these trials is appropriate at the current time. Trials would not be permitted at the moment."

All British xenotransplantation research, which has so far involved only pig-to-monkey transplants, has been halted because of disappointing results despite more than five years of effort.

The seemingly insurmountable problem of new untreatable diseases getting into humans from transplanted animal organs and the high cost of the work have put off investors.

The creators of Dolly the cloned sheep at the Roslin Institute near Edinburgh announced they were abandoning work on animal-to-human transplantation in August.

Three years ago, Baruah caused outrage in India when he performed the world's first pig-to-human transplant on Purno Saikia, 32. The patient regained consciousness after receiving the heart and lungs of a 14st pig, but died a week later, apparently from acute infection. The surgeon spent more than a month in jail before charges that he had contravened India's organ transplant act were dropped.

17 Dec 00 - Medicine - Schools may test for heart disease

Lois Rogers

Sunday Times... Sunday 17 December 2000

Children and teenagers are to be screened for early signs of heart disease under a project being developed by the government's National Screening Committee.

Under one of two proposals being considered, a nationwide programme would offer all 16-year-olds blood tests at school for high cholesterol. Alternatively, family members of people who develop heart disease as young adults may be offered the chance of screening.

Those at risk could then be treated with statins, a new generation of cholesterol-lowering drugs, which would mean taking a tablet daily for life .

Heart disease is Britain's biggest killer, accounting for four out of 10 deaths. It costs the nation 10 billion a year in terms of treatment and working days lost.

A significant proportion of victims suffer from inherited high cholesterol, where fatty deposits build up in blood vessels until they block them completely, often with fatal consequences.

One person in every 500 is affected by this condition and there are 110,000 sufferers nationwide. Half of them will have heart attacks before the age of 50. At present, very few are identified early.

Margaret Thorogood, a reader in public health and preventive medicine at the London School of Hygiene and Tropical Medicine, who produced the study of cholesterol screening for the NHS research programme, said: "If you are diagnosed at 16 with this condition you have a much better chance of a normal life span than if you are diagnosed at 35, when you already have clogged arteries.

"It does look as if it would be cost-effective to pick up people at an age when you can make a difference to their long-term health."

Final recommendations on how to implement a screening programme will be put to the government in the new year.

However, the British Heart Foundation said telling most 16-year-olds that their hearts were healthy could cause a new set of problems.

"Heart disease can be caused by a number of factors, including smoking, poor diet and lack of exercise, and teenagers should not be led to believe that a low cholesterol reading is an excuse to pursue an unhealthy lifestyle," said a spokesman.

17 Dec 00 - Medicine - Doctors want right to send patients abroad

By Robert Mendick

Independent... Sunday 17 December 2000

British Hospitals have taken the extraordinary step of demanding the right to send their patients to France and Belgium for surgery to relieve waiting lists.

East Kent Health Authority has asked the Department of Health to relax guidelines to allow patients under its care to receive NHS treatment in hospitals in Calais, Lille, Brussels, Bruges and Boulogne. Patients willing to go private but unwilling to pay high charges in the UK are also tempted to go to France and Belgium.

The potential demand has prompted two former Kent GPs to set up a consultancy called Global Op Ltd to arrange treatment on the Continent. "In some instances the cost of operations can be as much as 50 per cent lower. And the hospitals over there are absolutely super," said Norman Girolami, chairman of Global Op.

According to the British Cardiac Patients Association, bypass operations in Belgium and France are about one-third cheaper than in the UK. Stephen Ladyman, Labour MP for Thanet South, who has given his backing to East Kent's proposal to treat NHS patients abroad, said: "Certainly there is evidence that the private sector in this country is a rip-off."

Meanwhile, the Belgian embassy in London is understood to receive calls on a daily basis from people all over the UK inquiring about heart operations there.

Prices for operations around the world vary widely from country to country and British people, frustrated by NHS waiting lists, are waking up to the possibilities of undergoing surgery in other countries, including India, Cuba and Russia.

The proposal by Kent health authorities to buy treatment in France for their patients - the first of its kind - is likely to attract the interest of other health authorities along the English south coast. It can be as quick to reach a French or Belgian hospital via the Channel tunnel as a specialist London hospital.

"Across the Channel they have a lot of spare capacity, very short waiting lists and as far as we can see very good facilities," commented Mark Outhwaite, East Kent health authority's chief executive. "Certainly it is not going to solve all the problems but it would make a significant difference."

East Kent, with 600,000 people under its care, currently has 74 patients on its books who have been waiting six months or more for heart bypass surgery. The average waiting time for such patients is 10 months. There are 195 patients waiting 12 months or more for hip replacements - the average waiting time is again 10 months.

Patients should be given the choice of either waiting for an English bed to become available or the chance of quicker treatment by travelling to France or Belgium, said Mr Outhwaite.

He pointed out that the University Campus Hospital in Lille, for example, is a renowned centre of excellence for heart operations. "We would put patients on the train at Ashford or use a private ambulance or minibus to ferry them on Le Shuttle. They can be in Lille in two hours. If you actually work out how long it takes to get up to London, the journey isn't a bad deal and a lot more comfortable," he explained.

Current NHS rules state that public money can be spent on operations abroad only if the treatment is so specialised that it is not available in the UK. But East Kent believes the signing of a concordat at the end of October between the private sector and the NHS, which allows health authorities to use private hospitals for NHS treatment on a regular, formalised basis, opens the way for those patients to go to private hospitals on the Continent.

Mr Outhwaite speculated that the Department of Health could be in breach of European Union competition rules if it did not allow NHS patients to receive treatment abroad. The department, however, remained resistant to the idea last night. It issued a statement saying: "The concordat makes it easier for the NHS to work with the private hospitals in this country, to make use of their spare capacity. Given that London and the South- east have the highest proportion of private hospitals in the country, there should be no shortage of choice for the NHS to buy private capacity, of a high standard, nearby and free for NHS patients."

However, Mr Outhwaite said the UK's private sector could not solve its problems because the shortages were not caused by a lack of operating theatres but by a lack of medical staff to carry out treatments.

15 Dec 00 - Medicine - Fruit flies reveal Holy Grail of long life

By Mark Henderson, Science Correspondent

Times... Friday 15 December 2000

A Gene named "I'm not dead yet", in honour of a line from the film Monty Python and the Holy Grail, has been found to double the lifespan of fruit flies, scientists announced yesterday.

The discovery will make it easier for scientists to understand the ageing process in other species, including human beings. The fruit fly is a model laboratory animal which is used widely for studying basic genetic changes.

Fruit flies with a mutated copy of the gene, known as "Indy" for short, live between 69 and 71 days, compared with a normal lifespan of 37 days, according to new research at the US National Institute on Ageing, in Connecticut.

The gene was named after a scene in the Monty Python film in which a medieval undertaker, played by Eric Idle, collects the bodies of plague victims on his cart. When a householder, played by John Cleese, throws an old man on the cart, he complains: "I'm not dead yet!"

The Indy gene mutation, details of which were published yesterday in the journal Science, appears to work by changing the way fruit flies use and store energy. That conclusion fits with the findings of several previous studies, which have suggested that some laboratory animals can live longer if they eat fewer calories than normal, while still maintaining a nutritious and balanced diet.

Flies with the Indy gene continue to be healthy despite advancing age and females remain fertile for 40 per cent longer.

The results of the Indy gene research could one day assist the development of new drugs to prolong lifespan or improve the quality of life in old age in human beings, according to the research team led by Stephen Helfand of the University of Connecticut. "Further characterisation of Indy mutants may provide direct genetic insight into the role of energy balance and ageing, and a point of access for genetic and pharmacological interventions for extending lifespan," Dr Helfand said.

David Finkelstein, research director for metabolic regulation research at the National Institute on Ageing, said: "What is interesting about this line of research is the recurrence of the link between metabolism, calorific restriction and longevity. This study points to the possibility that if you genetically alter metabolism, you can alter lifespan."

Elizabeth Mills, director of the British charity Research into Ageing, said: "These are fascinating results that look pretty significant. Anything we can use to identify influences on life expectancy is going to help us to achieve our main goal, which is to extend the age to which people live a healthy life. This is obviously a long way off human applications, but it is likely to prove very useful."

The fruit fly, Drosophila melanogaster, is one of the most commonly used of all laboratory creatures in genetic research, as almost all the genes involved in its development are also at work in larger organisms, including humans.

It breeds easily in the laboratory, and its short lifespan (without the Indy gene) means that scientists can create many generations in short periods of time to observe how genes flow from parents to children.

The fly's complete genome has been mapped by the US company Celera, which caused controversy by sequencing the human genome with a view to commercialising the results. A public sector project at the University of California at Berkeley is also producing a gene sequence for the insect.

"The great thing about fruit flies is that they are a simplified form of higher animal and human life, with similar genetic processes," Ms Mills said.

"That means we can do a lot of basic research there, and replicate in 20 to 30 days what happens in humans over 60 to 70 years. It is like the fast forward button on a tape machine."


15 Dec 00 - Medicine - PPL moves from Dolly to cows

Andrew Clark

Guardian... Friday 15 December 2000

Biotech company PPL Therapeutics - which created Dolly, the world's first cloned sheep - is diversifying into genetically modified cows through a tie-up with a New Zealand research institute.

The company has agreed a joint venture with Celentis, a company backed by the New Zealand government, to clone cows which secrete a human protein in their milk for the treatment of multiple sclerosis.

If successful, research will move on to producing the human serum albumin in cows' milk to treat burns, and adapting cattle to produce nutritional products to aid digestion.

PPL's chief executive, Ron James, said the company was working outside Europe to avoid the risk of Mad Cow disease: "New Zealand is a good place to have your cattle. We chose to work in New Zealand and America some time ago because we could see problems looming with BSE."

PPL has dabbled with cattle before - the company's US subsidiary produced Mr Jefferson, its first cloned cow, in 1998. However, its in-house work on cows stopped as part of a cost-cutting drive last year.

Under the terms of yesterday's deal, Celentis will fund research on the first three products, taking advantage of PPL's patented cloning techniques. Beyond that, the cost will be split equally between the two partners.

Analysts said the agreement made sense for cash-strapped PPL. Julie Simmonds of stockbroker Beeson Gregory said: "It's a way of them expanding their pipeline without having too much to worry about financially."

The Edinburgh-based company is one of the world leaders in cloning. It has exclusive rights to genetics technology developed by the Roslin Institute.

The company struck a deal with the German firm Bayer this year to commercialise a cystic fibrosis treatment produced in sheep's milk. PPL is also attempting to grow human hearts and lungs in pigs, to satisfy demand from transplant patients.

15 Dec 00 - Medicine - Doctors doubt value of breast cancer tests

By Jeremy Laurance, Health Editor

Independent... Friday 15 December 2000

Two cancer specialists cast new doubt on the breast screening programme yesterday by claiming that advances in treatment have been 200 times greater than in screening.

Professor Michael Baum of the Royal Free and University College medical school and Jeffrey Tobias, consultant in radiotherapy and oncology at University College Hospital, both in London, said switching funds from screening into treatment would be better value for the NHS's money.

In a letter to the British Medical Journal, they calculate that advances in surgery, chemotherapy and hormonal treatment mean that 100 more women out of every 1,000 treated are alive today than might have been 10 years ago.

By contrast, the breast screening programme is saving 1 woman in every 2,000 women invited for screening, according to the first evaluation of the programme, which was published three months ago.

The doctors write: "The figures are self-evident, yet it is galling how the political spin from government agencies suggests that the best way of reducing deaths from breast cancer lies in trawling through the asymptomatic population [women without symptoms of the disease]. We suggest that greater investment in the quality of care and research related to treatment could be much more efficient."

A study of the breast screening programme, which was done by Dr Roger Blanks of the Institute of Cancer Research -also published in the British Medical Journal - concluded that the screening programme had cut the death rate from breast cancer by 6.4 per cent since 1990. This figure was well below the target set by the Department of Health, which aimed for a 25 per cent reduction in deaths by 2000.

14 Dec 00 - Medicine - Scientists find insect gene that may hold clues to human ageing

By Charles Arthur, Technology Editor

Independent... Thursday 14 December 2000

The elixir of youth has been discovered - at least for fruitflies. A mutation in a single gene can double their lifespan, scientists said yesterday, and it could have implications for human ageing.

The mutant gene, called Indy ("I'm Not Dead Yet") produces a protein involved in the metabolism and, importantly, has a human counterpart. Scientists found that Indy, which contains five DNA alterations compared with the normal version found in most flies, extended the lifespan of Drosophila fruitflies from 37 days to 71 days: they ate normal amounts of food, stayed active and remained fertile. Another strategy tested on animals, restricting calorie intake, also lengthened lifespan but reduced vivacity.

The effects of Indy appear unique in lifespan studies. The researchers who discovered it, from the National Institute on Ageing in Connecticut, believe it fundamentally changes the flies' metabolism - that is, the way they store and use energy.

Dr David Finkelstein, of the National Institute on Ageing, who led the research published today in the journal Science, said: "This study points to the possibility that if you genetically alter metabolism, you can alter lifespan." The promise of longer life for humans is still distant, however. While fruitflies and humans share 80 per cent of their DNA, Dr Finkelstein said: "We are still many steps away from understanding how caloric restriction may affect human lifespan."

13 Dec 00 - Medicine - Bladder cancer linked to smoking

By Nigel Hawkes, Health Editor

Times... Wednesday 13 December 2000

Smokers run a much greater risk than non-smokers of contracting bladder cancer. But their chances of avoiding it are improved if they also drink coffee.

This mixed message is the result of a survey in Spain of all cases of bladder cancer being treated in 12 general hospitals across the country over a 12-month period - more than 500 patients in all.

All patients, and a comparison group of more than 1,000 people, supplied details of employment history, tobacco use, diet and coffee consumption.

Earlier studies have shown that drinking a lot of fluids, including coffee, cuts the risk of bladder cancer. The Spanish study, published in Journal of Epidemiology and Community Health, shows that this also applies among those who smoke - though coffee cannot entirely counteract smoking.

A team from the National Epidemiology Centre at Carlos III Health Institute in Madrid compared the chances of getting bladder cancer in smokers who drank more than two cups of coffee a week against those who drank fewer than two cups a week.

Smokers who do not drink coffee are seven times more likely to get bladder cancer. But those who do are only three times more likely to get the disease. In other words, among smokers, drinking coffee more than halves the risk.

The team suggests that coffee may moderate harmful effects of cancer-causing agents in tobacco. But they say their evidence suggests that the risks of getting bladder cancer as a result of smoking are far higher than was thought.

The endless flow of new cancer research is of concern to callers to Britain's foremost advisory service on the disease, CancerBACUP, one of the two causes that readers of The Times are being asked to help in the newspaper's Christmas Appeal.

13 Dec 00 - Medicine - New limits for stem cell research

By Roland Watson, Chief Political Correspondent

Times... Wednesday 13 December 2000

Ministers tried to head off mounting criticism of their approach to the highly contentious issue of stem cell research last night by clarifying the Government's guidelines.

Alan Milburn, the Health Secretary, published a revised parliamentary order which stressed that the use of human embryos in scientific research would be geared towards serious diseases. A previous draft order had prompted opposition from MPs and sectors of the medical profession by appearing to suggest that embryo research could be permitted in work on minor complaints or ailments.

The new guidelines come amid mounting anxiety in government at the strength of opposition to the proposals among some Labour MPs as well as a fierce campaign led by religious groups.

The guidelines are based on the advice of Professor Liam Donaldson, the Chief Medical Officer, who has recommended the use of human embryos in research.

But the Department of Health issued a significantly tighter definition last night, saying that stem cell research would be allowed in search for cures to diseases such as Parkinson's, diabetes and cancer, but not to lesser ailments.

A spokesman for the Health Department said: "We were happy to make this change. We will ensure the regulations contain protections as well as unlocking this technology to tackle serious diseases."

Liam Fox, the Tory health spokesman, said backtracking showed the "contempt and determination to speed it through the Commons".

12 Dec 00 - Medicine -Cannabis can halt 'fertility signals'

By David Derbyshire, Science Correspondent

Telegraph... Tuesday 12 December 2000

Cannabis smokers may be lowering their chances of having children, according to research.

Scientists have discovered that chemicals in the drug can overload an important signalling system in the brain which is involved in fertility. When consumed by men or women, marijuana can make sperm sluggish, reduce the chances of it breaking through the surface of an egg and hinder the development of a newly-fertilised embryo.

Dr Herbert Schuel, from the University at Buffalo, New York State, who presented the findings at the annual meeting of the American Society for Cell Biology, said: "These findings suggest that defects in the cannabinoid receptor-signalling system could account for certain types of infertility.

"A better understanding of these mechanisms might lead to the development of novel drugs useful in reproductive medicine. For heavy marijuana users, the study results raise the possibility that they are jeopardizing fertility by overloading this signalling system."

In the 1980s, scientists found a chemical signalling system in the brain that responded to THC, the active substance in marijuana. A couple of years ago they identified the natural brain molecule anandamide that activates these cannabinoid receptors.

Dr Schuel's team has now found the first evidence that anandamide exists in three substances involved in fertility: human seminal plasma, mid-cycle oviductal fluid and follicular fluid.

Human sperm is not immediately capable of fertilising sperm after ejaculation. Only when they have been exposed to secretions inside a woman are they able to fertilise eggs, a process called "capacitation".

12 Dec 00 - Medicine -Flyers with blood clots sue airlines

Patrick Barkham in Sydney

Guardian... Tuesday 12 December 2000

Dozens of Australians who suffered potentially fatal blood clots after flying long distances in cramped conditions are preparing to sue leading airlines, including British Airways, for failing to warn them about the so-called "economy class syndrome".

In the first attempt to seek damages for passengers who suffered deep vein thrombosis (DVT) after long-haul flights, Slater and Gordon, a Melbourne-based law firm, said it would issue writs against at least five airlines.

Paul Henderson, a member of the firm, said he had received calls from more than 100 people who had suffered blood clots after flying from Australia to London, Canada the US and other distinations.

Two months ago Emma Christoffersen, 28, from Wales, died after developing a fatal clot on a 20-hour Qantas economy-class flight from Australia and losing consciousness in the Heathrow arrivals lounge.

Mr Henderson alleged there were 60 deaths a year at Heathrow airport from blood clots. He said: "The big issue is the failure to warn of the risk, and failure to advise of steps that might be taken to reduce the risk, as well as the failure to advise and warn of early onset of symptoms.

"There's no doubt that if the airline warns of the risk appropriately and takes some fairly simple measures to reduce the risk, then they will not be sued. And that's the very disappointing thing. They knew of this risk for some time and they appear to have put their head in the sand."

Mr Henderson confirmed that he would represent passengers aged from their early 20s to mid-60s who had flown on Qantas, British Airways, Air France, Air New Zealand and Emirates, but warned that others could also be targeted.

A spokesperson for Qantas admitted yesterday that it had not previously warned passengers of the risks widely linked to staying immobile for long periods of time on flights, "but we've certainly encouraged people to perform a series of exercises while seated".

Qantas said that inflight videos warning of blood clots and advising preventative in-seat exercises would be introduced at the start of every section of a long-haul journey by the end of January. Its December in-flight magazine is its first to specifically warn about the potential dangers.

The compensation claims, estimated to be each worth up to 22,500, will not necessarily encourage similar actions in Britain because Australian laws make it easier to mount a class action.

A House of Lords report criticised airlines last month for "woefully neglecting" passengers' health and called for warnings on long-haul tickets. But it accepted there was not yet any conclusive proof of the link between DVT and flying, and also said the condition should not be called "economy class syndrome" as immobility, not lack of space, appeared to be the key trigger.

It said that one in 1,000 people will develop the condition each year. Pregnant women and women on hormone replacement treatment or the pill, smokers, and those with heart disease are most at risk.

12 Dec 00 - Medicine - Sugar gel breast implants banned

By David Charter, Health Correspondent

Times... Tuesday 12 December 2000

A type of breast implant used by more than 4,000 women was banned by the Government yesterday after fears over its long-term safety.

The Medical Devices Agency said that surgeons should not fit hydrogel-filled implants until the makers could guarantee that the substance caused no harm. The agency is not advising women to have implants removed because there are no known cases of physical harm. The ban is a precautionary step.

Implants containing hydrogel - a mixture of salt, water and sugar - were introduced in 1994 after fears about the safety of silicone gel, used in the the most common implant. About 4,000 women in Britain have been fitted with French PIP Hydrogel implants and 250 with NovaGold, a German brand.

The directive means that implants made of silicone gel and saline are the only options for the 8,000 women who yearly opt for breast enlargement in Britain. The ban comes after official advice this summer that 5,000 women fitted with Trilucent soya implants, another alternative to silicone, should have them removed because of the risk of toxic leaks.

Maxine Heasman, of the Breast Implant Information Society, said that there was no immediate cause for concern. "We have always warned women that if they are using either of these two implants they will be guinea pigs. While they seem like a good alternative to silicone, nobody knows what the long-term effects will be."

She said that the ban was yet another terrible blow for the industry, which had suffered "scare-mongering" over alleged health risks linked to silicone implants. She insisted that evidence showed silicone to be safe, and she knew women who had silicone implants for 30 years without problems.

The British supplier of PIP Hydrogel said that it found the agency's decision "alarmist".

Dr Pat Troop, Deputy Chief Medical Officer, said that no definite health risk had been identified to women with the implants or their children. "The recall is purely a precautionary measure," he said.

Clive Orton, president of the British Association of Aesthetic Plastic Surgeons, said that he was not surprised to hear that hydrogel was being withdrawn because "there has not been substantial literature on this implant".

Christine Fogg, chief executive of Breast Cancer Care, said: "There is no information to indicate any risk to women with these implants. We urge any woman with this type of implant not to panic, but to speak to their surgeon or GP."

12 Dec 00 - Medicine - Row on age limit for the morning after Pill

By Mark Henderson, Science Correspondent

Times... Tuesday 12 December 2000

Doctors urged the Government yesterday to extend the rules and allow girls under 16 the morning-after Pill over the counter.

The British Medical Association's general practitioners committee said that the emergency contraceptive, which can be taken up to 72 hours after intercourse, should be supplied by pharmacists without prescription to anyone who needed it.

Under new regulations announced by Alan Milburn, the Health Secretary, which will come into force on New Year's Day, chemists will only be allowed to sell it to women over 16. Younger girls must still see a doctor.

John Chisholm, chairman of the BMA committee, said that successful pilot projects in Manchester and South London in which there was no age-limit to the morning-after Pill being supplied over the counter should have been extended nationally.

"We welcome the Secretary of State's decision but would have liked him to go further," he said.

"If pharmacists can assess if it is appropriate for someone to have post-coital contraception, they should be able to assess if girls under 16 should receive it."

He added that the morning-after Pill, which is expected to cost 20, should be free, particularly as younger teenagers are less likely to afford it.

"It is important to reach all those at risk if you are really trying to bring down the number of teenage pregnancies," he said.

Liam Fox, the Shadow Health Secretary who is also a GP, said that the BMA was wrong to demand so liberal a regime. "Making the morning-after Pill available in this way sends the wrong message about the need for responsible sexual activity," he said.

The controversy over making the morning-after Pill available over the counter deepened further yesterday after a group of doctors at the University of Exeter disclosed that a study had found that most women who had taken it did not want it to made so available. The study of 572 women who received emergency contraception from Devon family planning clinics and GPs found that most women felt it should be supplied only by doctors.

12 Dec 00 - Medicine - 'Unsafe' hydrogel breast implant is withdrawn from sale

By Jeremy Laurance

Independent... Tuesday 12 December 2000

A second type of breast implant was withdrawn from sale yesterday after government investigators concluded it could not be regarded as safe.

The implants, given to about 4,250 women in Britain, are filled with hydrogel , a plastic material that swells in water. The makers of the implants withdrew them from the market after the Medical Devices Agency (MDA), which has been examining breast implants, said safety assessments done on the hydrogel fillings had been inadequate.

Last year soya-oil breast implants were withdrawn from sale amid safety fears. Women who had them - about 5,000 in Britain - were later advised to have them removed.

Both types of implant were introduced in the mid-1990s in response to fears over the safety of silicone implants, which remain on the market.

The latest withdrawal is certain to heighten anxiety about the safety of all implants, despite government reassurance yesterday that there was no need for women with the hydrogel type to have them removed. Unlike the soya-oil implants, which leaked and caused reactions in scores of women, there have been no reports of problems or complaints about the hydrogel kind.

Dr Pat Troop, the Government's deputy chief medical officer, said: "It must be stressed that no definite health risk has been identified. At present there is no information to indicate that there is any risk to women with these implants, or their children. The recall is purely a precautionary measure, until the manufacturers have addressed MDA's concerns regarding their biological safety assessments."

The Department of Health said the MDA's review had revealed inadequacies in the makers' biological safety assessments on two brands of the implants and concluded that there was not enough information to assess either of their filler materials fully.

"No definite risk has been identified. There are no known cases of harm caused by these breast implants and there is no evidence to suggest they should be removed from women who currently have them. The concern is only with the way the safety of the hydrogel fillers has been assessed," the department said.

The first product affected by the warning is the PIP hydrogel breast implant, made in France and supplied in Britain by Clover Leaf Products. About 4,000 women in the UK have received these since they were introduced in 1994.

The second is the NovaGold implant, made in Germany and supplied in Britain by Somatech Medical . About 250 women have received these since they were introduced in 1996.

Hydrogels are used in other products, such as contact lenses, medicines, surgical dressings and food, but the department said these were not affected by the warning.

Women who have the implants and are concerned are advised to contact their surgeon or GP. About 80 per cent of hydrogel implants in use were inserted for cosmetic reasons by private clinics, the Department of Health said.

11 Dec 00 - Medicine - GPs rebel against flu drug advice

Sarah Boseley

Guardian... Monday 11 December 2000

A flagship of the government's NHS reforms, the national institute for clinical excellence, will face its biggest crisis this week as rebellion grows against its advice to GPs to prescribe the flu drug Relenza to the frail and elderly.

Last week a group of doctors in Devon said they did not intend to prescribe the drug to those at risk from complications of flu, flouting Nice's advice. More doctors are expected to follow their lead.

On Thursday the Drugs and Therapeutic Bulletin, which goes to all GPs, will announce that it remains "unconvinced of the benefits" of the drug and will not recommend its use.

The double challenge is a blow to the standing of Nice. It assesses the cost effectiveness of medicines and other treatments. If its committees of experts decide a drug is valuable, advice goes out to doctors to prescribe it. If they do not act on the advice they are likely to earn a black mark when their own performance is assessed.

But the mid-Devon group, which represents about 70 GPs and advises the primary care group, voted last week not to prescribe Relenza because it was not convinced that Nice's experts were right about it.

A year ago, a Nice evaluation committee rejected the drug on grounds that it would not help those at risk of flu complications because of a heart or lung condition or other frailty. The drug shortens a flu bout by a few days but has to be taken within 48 hours of the onset of symptoms.

Last month a review by a new Nice panel recommended that it should be given to at-risk groups in the light of new evidence from the manufacturer, GlaxoWellcome.

David Jenner, a GP in Cullompton, Devon, and chairman of the primary care group, said: "The doctors decided the weight of evidence was poor." They were also concerned that the drug was to be given out by nurses and pharmacists without reference to the GP.

"There is a particular problem with the diagnosis of flu: you get it wrong two times out of three. They were rebelling against the diktat from Nice, which made them feel that their individual clinical responsibility was being eroded."


11 Dec 00 - Medicine - NHS overspent on impotence drugs

Patrick Butler

Guardian... Monday 11 December 2000

The NHS spent between 5m and 8m more than it expected on impotence drugs such as Viagra last year, despite tight prescribing guidelines, the Department of Health has revealed.

The government today announced plans to re-open consultation with patients and professional groups on the current prescribing regulations, which were put in place in July 1999.

At that time it was estimated that the cost annually to the NHS for treating men with impotence would be between 12m and 14m - but figures to July 2000 show spending was about 20m.

Ministers originally imposed tight NHS prescribing rules, including restricting the drugs to men with certain medical conditions, and advising that doctors should limit patients to one treatment a week.

But the latest figures suggest that the restrictions have not been as successful in managing the NHS patient demand for impotence treatment that the government had hoped.

The consultation, which is open until February 5, 2001, is likely to re-open the controversy over whether so-called "lifestyle" drugs such as Viagra should be met by the NHS.

The original consultation on impotence drug treatments in 1999 showed that 75 per cent of respondents favoured limits on prescribing, while 10 per cent thought it should be banned.

A DoH spokesperson insisted that ministers had no view on whether the rules should be tightened but would wait for the results of the consultation, which had been promised at the time of the original decision last year.

But a DoH statement said: "These figures [the 20m annual expenditure] indicate that the government was correct to have concerns about the potential resource implications of more widespread prescribing of these treatments."

Drugs available on the NHS to treat impotence are: Viagra, Caberject, Muse and Viridal.

Under existing regulations, GPs are allowed to prescribe impotence treatments on the NHS to men who they consider to be clinically impotent and suffer from a list of specific conditions. These are diabetes, multiple sclerosis, Parkinson's disease, poliomyelitis, prostate cancer, prostatectomy, radical pelvic surgery, renal failure caused by transplant or dialysis, sever pelvic injury, soinal cord injury, spina bifida or single gene neurological disease.

The DoH said these limits represented "a sensible balance between treating men with the distressing condition of impotence and protecting the resources of the NHS to deal with other patients", for example those with cancer or heart disease.

Men who fall outside the regulations have to pay for the drugs by taking out a private prescription from their GP.

11 Dec 00 - Medicine - Breakthrough as scientists find way to make cannabis soluble

By Chris Gray

Independent... Monday 11 December 2000

Scientists have invented a technique for making cannabis soluble so that it can be used in sprays or injections , which would remove a key objection to its use as a medicine.

The team at Aberdeen University believes the breakthrough could lead to the drug being available on the NHS within five years.

GPs have opposed the drug's medicinal use because it had to be smoked, which carries a risk of cancer, or eaten, which is unreliable. Soluble cannabis could be administered to patients in sprays , aerosols or injections .

Professor Roger Pertwee, a reader in neuropharmacology at the university, has developed and patented the new cannabis compound with Dr Raj Razadan from Boston, Massachusetts, and Dr Billy Martin of Virginia.

Professor Pertwee said the compound still produced a "high" in users, but work was continuing on removing that without also stopping the drug's pain relieving qualities.

Professor Pertwee, is recognised as Britain's leading researcher into the drug's medicinal uses. His team's research has provoked interest from drug companies in Britain and in America, where some states allow cannabis to be used for medicinal purposes.

The medical use of cannabis was prohibited in Britain in 1971 but there has been growing pressure for that to be reversed. Many multiple sclerosis patients use the drug to relieve pain regardless of the ban.

11 Dec 00 - Medicine - Chinese doctors say herbal cures can combat Aids

By Calum MacLeod in Beijing

Independent... Monday 11 December 2000

As AIDS sweeps Asian countries, raising fears of an epidemic of African proportions, Chinese doctors believe they may be able to work a miracle with traditional Chinese medicines, such as ginseng and mulberry bark.

Experts suggest the number of HIV carriers in China will reach 10 million by the year 2010. But researchers like Professor Guang Chongfen, director of immunology at the China Academy of TCM in Beijing, say their arts hold the answers in the quest to find a cure for the virus.

Professor Guang's team has been conducting clinical trials in Tanzania since 1989. In the most complete experiment that concluded last year, he says 14 of 29 Aids patients responded positively to treatment with zhongyan erhao, a compound of eight different TCM standards, including ginseng.

Professor Luo Shide, of the Kunming Plant Research Institute, under the Chinese Academy of Sciences, claims a higher success rate for his compound SH drug. After sifting though over 1,000 medicinal herbs, Professor Luo selected the bark of white mulberry root and four other Chinese plants. "This year we tested SH on 28 patients in Thailand," he told The Independent. "Nine showed obvious reductions in viral concentration, while 16 others showed no increase after three months' treatment."

As Third World countries struggle with the cost of Western medicines, Chinese discoveries offer hope of more affordable cures. "There is no vaccine for Aids", says Professor Guang, "and no compound can cure it yet, but Chinese medicines can inhibit the growth of the virus and improve patients' immunity. Although TCM is slower to act than Western medicine, it offers longer-lasting results, with no side-effects or resistance and, above all, it is cheap."

The biggest challenge is funding. "There is so much discrimination in society towards Aids sufferers that people are afraid to admit they have the disease," explains Professor Guang. "This means no one knows exactly how many people have Aids in China, and this influences how much funding the government gives."

Official statistics suggest there are only 20,000 registered cases. Unofficially, the government accepts there are up to one million. The number is climbing by more than 30 per cent a year.

11 Dec 00 - Medicine - Medical experts are alarmed by rise in fraudulent research

By Jeremy Laurance, Health Editor

Independent... Monday 11 December 2000

Britain's medical establishment is facing a series of allegations of fraudulent research, which experts fear could undermine confidence in scientific findings.

More than a dozen cases involving doctors charged with research fraud will be heard by the General Medical Council (GMC) during the next year.

Today, two doctors are due to appear before the GMC in connection with a case in which a 66-year-old man, Alan Bowler, died during a trial of the heart drug Manoplax, which has since been withdrawn. His family received 210,000 compensation in an out-of-court settlement three years ago.

Dr Robert Davies, now a consultant cardiologist at Chase Farm Hospital in Hertfordshire, is alleged to have inappropriately included Mr Bowler in the study and given him inappropriate care.

Professor Desmond Sheridan, of St Mary's Hospital, London, is charged with failing to supervise Dr Davies properly and with providing misleading statements to the family about the cause of the death in 1992.

The study involved threading a catheter into the patient's heart, but Mr Bowler's heart was so damaged that the procedure was dangerous. It is understood Professor Sheridan told the family that Mr Bowler had died of a heart attack but did not mention the patient's role in the drug trial.

A second case involves allegations of fraudulent research at King's College Hospital in London in the early 1990s, in which laboratory books containing evidence are said to have been shredded and whistleblowers told not to talk.

Last week, Anjan Kumar Bannerjee, now a consultant surgeon at the Royal Halifax Infirmary, was found guilty of research fraud at King's in the 1990s when he was a junior doctor. The GMC found he had substituted his own urine for that of 12 healthy adults in a study and published a fraudulent article, in the medical journal Gut, based on the results. His supervisor, Timothy Peters, Professor of Clinical Biochemistry, is to appear before the GMC in the new year, charged in connection with the case.

Dr Bannerjee was reported to the GMC by Dr Peter Wilmshurst, a consultant cardiologist at the Royal Shrewsbury Hospital, who has campaigned against research fraud for many years. He said he had reported "at least a dozen" cases of suspected fraud to the GMC.

"It was stated at the GMC that some of the whistleblowers were told if they didn't keep quiet their careers would suffer. It was also said at the hearing that the laboratory books relating to Mr Bannerjee were shredded," Dr Wilmshurst said.

He said Dr Bannerjee had published 49 papers while still a junior doctor, which was "unheard of". London University gave him a Master of Surgery degree, despite being made aware of concerns about his research. "I have documents which show that they were told that the research in his thesis was fraudulent," Dr Wilms-hurst said.

King's College denied that it had been involved in any kind of cover-up, although the college confirmed that Professor Peters was due to appear before the GMC and said the allegations were "unfounded. The college is astounded that Dr Wilmshurst is reporting allegations against the college which are unwarranted..." it said.

Tomorrow, the Committee on Publication Ethics, a group of editors of medical journals backed by the British Medical Journal and The Lancet, will announce new measures to tackle scientific fraud.

11 Dec 00 - Medicine - New tests to identify unhealthy embryos

By Marie Woolf, Chief Political Correspondent

Independent... Monday 11 December 2000

A new generation of genetic tests that would allow parents to select healthy babies is being considered for licensing by Britain's fertility watchdog.

The tests, likely to be offered to parents having fertility treatment, would allow doctors to detect embryos with conditions such as Down's syndrome and discard them before they were implanted in the mother. The new form of genetic screening would also enable parents to discard embryos that werelikely to miscarry, thus improving the success rate of IVF treatment.

The fertility watchdog will also consider licensing the selection of embryos that have the potential to save dangerously ill siblings because they contain genetically compatible material. This follows the case of Molly Nash, an American girl whose life was endangered by a rare genetic form of anaemia. She was given a transplant using cells from the umbilical cord of her baby brother, Adam. Her brother's embryo was checked to see if he carried the gene responsible for his sister's condition.

Doctors believe licensing such genetic tests in Britain would help to reduce the risk of miscarriage because embryos with an abnormal number of chromosomes are more prone to abort. It would also enable them to screen for fatal illnesses such as Edward's syndrome, which leads to severe mental and physical disability in newborns and an early death for most children.

Such testing is likely to provoke accusations that doctors are trying to create "perfect babies" or playing God. It will raise fears that embryos lacking a perfect chromosonal make-up will be discarded. Pro-life groups have condemned such tests as a step towards creating so-called designer babies.

"This will lead to a designer baby culture. Once one has overstepped this mark and uses genetic manipulation for one reason its going to be difficult to stop it for other reasons," said Paul Tully, general secretary of the Society for the Protection of Unborn Children. "Testing for Down's syndrome usually means a fatal outcome. This sort of testing assumes that people with some genetic anomaly have less right to live."

The new form of aneuploid pre-implantation screening, which has never been licensed for use in Britain, would involve checking to see if embryos' DNA have abnormalities in chromosomes. "Aneuploid testing" involves removing a cell from the embryo and checking if the full number of chromosomes are present.

The technique would reduce the failure rate of treatment for infertile couples because it would allow doctors to screen out embryos with abnormalities that cause miscarriages. Pre-implantation genetic diagnosis is used at clinics in Britain to check for hereditary diseases such as cystic fibrosis, which can be detected from genetic abnormalities.

But doctors have been licensed to examine only five chromosomes for abnormalities, including cystic fibrosis and Huntington's disease.

11 Dec 00 - Medicine - Alzheimer drugs 'may be harmful'

By Celia Hall, Medical Editor

Telegraph... Monday 11 December 2000

Thousands of elderly people suffering from Alzheimer's disease and dementia are being prescribed drugs that could be making their symptoms worse , researchers said yesterday.

An estimated 30,000 people a year, most of them living in residential and nursing homes, are being given the drugs inappropriately. Neuroleptics, also called major tranquillisers, are prescribed to make patients quieter and more manageable. British research, to be published in the New Year, says that there is evidence that they are given too freely.

Researchers say the drugs are too often used instead of nursing care and that vulnerable people are often inadequately monitored. Dr Clive Ballard, of the Institute for the Health of the Elderly at Newcastle General Hospital, led the study. He said yesterday: "It is indisputable that the drugs are over prescribed.

"There is a fear that if they are discontinued there will be problems in care homes, but this is not the experience in America where there is now legislation that restricts prescribing. There is a problem that the drugs are used as a substitute for good, practical care management. There needs to be investment in the proper training of staff."

Dr Ballard and colleagues found that those taking the drugs suffered significantly reduced well-being, spent more time socially withdrawn and less time engaged in activities.

His research looked at a range of psychotropic drugs, those that have an effect on the mind, including neuroleptics. Patients taking neuroleptics were the worst affected. The research, to be published in the journal International Psychogeriatrics, says that many patients did not need the drugs, which could be detrimental to them.

Dr Ballard writes: "This is particularly true for psychotropic drugs, which had a substantially more deleterious effect upon quality of life than the target symptoms for which they were prescribed."

In his study, 209 elderly people with dementia living in four residential and two nursing homes in Newcastle were identified. A third of these was not taking drugs. In a rating of quality of life 11 per cent had "ill-being", 24 per cent had poor well-being and 64 per cent had fair or good well-being.

Only a small number of people had severe behavioural and psychological symptoms of dementia but most were receiving drugs. He writes: "People taking neuroleptics were particularly at risk of 'ill-being'."

Dr Ballard found that more than 40 per cent of those studied were taking a neuroleptic drug, many of whom did not have clinically significant symptoms. "Either the treatment was initiated inappropriately or the treatment had not been reviewed following the resolution of the target symptom."

Dr Ballard is about to begin a five-year study of the effect of discontinuing a neuroleptic drug in people with dementia. Some 530,000 people suffer from Alzheimer's disease and 60,000 a year die.

11 Dec 00 - Medicine - Morning-after pill for sale at 20 in New Year

By Sally Pook

Telegraph... Monday 11 December 2000

The morning-after pill will go on sale at chemists from the New Year in a Government attempt to reduce unwanted pregnancies.

Any woman over the age of 16 will be able to buy it without prescription for about 20. The Government is committed to halving teenage pregnancy rates, the highest in Europe, by 2010. The change in the law will come into force on New Year's Day, although the pill is not expected to be widely available until late January.

Pharmacists will be under strict orders from the Royal Pharmaceutical Society not to supply it to girls under 16. A pharmacist must be present before it can be sold and women will not simply be able to pick it up from a shelf. The move has been welcomed by women's health groups but condemned by pro-family campaigners. The Tories said yesterday that they would reverse the "alarming and appalling " decision when in office.

The Department of Health said that the pill should not be regarded as a substitute for regular contraception. A spokesman said: "We have thought very carefully about this and we understand the moral issues. This is about women over the age of 16, mature women who are sexually active, being able to have access to emergency contraception."

The pill, called Levonelle, has to be taken in two doses within 72 hours of unprotected sexual intercourse. It works by preventing or delaying ovulation. Anti-abortion groups claim that it causes abortion, but medical experts say that it works before implantation of a fertilised egg in the womb and therefore before a pregnancy has been established.

Ann Furedi, of the British Pregnancy Advisory Service, the largest provider of abortions, said that use of the morning-after pill was "hugely responsible" in the face of a potential unwanted pregnancy. She said: "I would argue that it is immoral to hinder women from preventing an unwanted pregnancy by means which are acceptable to them. The morning-after pill is safe, effective and is not a method of abortion.

"Many of the women we see would have used emergency contraception had it been more accessible. Often they are deterred by the hassle of making a doctor's appointment and also by the embarrassment of having to discuss their needs for emergency contraception."

Jenny Tong, Liberal Democrat MP and a family planning doctor for 20 years, said: "I have campaigned long and hard for women to be able to control their fertility in this safe and effective way."

Dr Liam Fox, the shadow health secretary, said he was "alarmed and appalled" by the decision. It would send out the wrong message about the need for responsible sexual activity. He said: "This can only increase the risk of worsening the epidemic of sexually transmitted disease and could result in repeated and unsupervised exposure of young girls to this powerful drug. On top of all this, many people will have a moral objection to the widespread availability of the morning-after pill."

Valerie Riches, founder of Family and Youth Concern, said that the availability of the pill would provide girls with a no-questions-asked abortion. She said: "There is also a danger that sexually transmitted diseases, on the increase among young women, could become rife as a result. It is a licence for promiscuity."

The Roman Catholic Church in England and Wales said: "That the Government wants to allow teenagers to buy this morning-after pill so freely and without a doctor's supervision is misguided and potentially dangerous. Encouraging casual attitudes to sex is not an effective or safe way of reducing teenage pregnancies." The Church said that it was misleading to say that the action of the pill was not effectively an abortion.