A picture of a man with a nose on his forehead caught my attention as I was scrolling down the BBC News website.

It turned out that surgeons in China had spent nine months growing a nose on the forehead of a man whose original nose was damaged beyond repair in a traffic accident.

The surgeons had expanded the skin on the man’s forehead and then placed under it a piece of cartilage taken from his ribs. The forehead was used as the skin there is similar to that of a nose, furthermore the nose can be moved keeping blood vessels in place. The surgery left is said to be the easiest part.

The concept of growing additional parts isn’t a new one.  The report goes on to mention the ear that was grown on the back of a mouse in University of Massachusetts Medical School (Vacanti Mouse). A wire framework of an ear was made and tissues taken from cows and sheep were grown around. The structure was then attached to the back of a mouse whose immune system had been suppressed.

I also learnt of the nose that was grown on the arm of a patient who had lost his to cancer by doctors from the University College London. A glass mould of the man’s nose was taken, bone marrow cells were extracted and place in the mould. This was then grown in the lab. The nose was then transplanted on the man’s arm so that it could develop blood vessels and nerves. After that it would be placed on his face. (Jan, 2013)

China however is increasingly becoming the place to watch for medical advancements, with the government has spending “trillions of pounds on innovation.”¹

1 http://www.bbc.co.uk/news/world-asia-china-24282498

_{http://www.bbc.co.uk/news/health-23508688}

_{http://www.dailymail.co.uk/sciencetech/article-2266689/Cancer-victim-growing-new-nose-arm-Businessman-lost-organ-disease-hopes-new-sewn-face.html?ito=feeds-newsxml}

The Impact the Syrian War has had on Health

The UN estimate that since the fighting in Syria begun two and a half years ago 100,000 people have been killed by the fighting. Recently there have also been figures highlighting the number of people presumed to be killed by chemical weapons, but I haven’t yet come across statistics outlining the number of casualties taken by secondary effects of the war.

By secondary effects I mean the resultant food shortages, the lack of water reaching refugee camps and the spread of disease. Before the reading a article on the New Scientist’s website, I hadn’t considered how the crisis in Syria was affecting the spread of disease, I’ve now learnt that it isn’t just the displaced Syrians whose health is being compromised but also the populations of the neighbouring countries.

The war has disrupted local health services, giving way to a large outbreak of measles in Northern Syria, further hindering the measles eradication efforts in the region. Médecins sans Frontières was hard put to deliver vaccines to the remaining inhabitants. The children arriving in refugee camps are all receiving vaccines for polio and measles. 

These camps however are full to the breaking, unsurprisingly with a quarter of the Syrian population now displaced, 2 million Syrians now call these camps home. These cramped conditions have accelerated the spread of:

-       ‘lung and gut infections’

-       hepatitis (the inflammation of the liver, most types are caused by viruses, symptoms include dark-coloured urine and pale bowel movements, jaundice …)

-       tuberculosis (is caused by bacteria that primarily damage the lungs, the bacteria is spread by sneezing and coughing, common symptoms include a bad cough, coughing up blood/mucus, night sweats …)

-       leishmaniasis (a parasitic disease caused by the bite of infected sand flies, there are several variations of the disease, common forms include the cutaneous type that causes skin sores and the visceral type which affects the spleen, liver, and bone marrow)

Neighbouring Jordan has received a large proportion of the Syrian refugees; tuberculosis was close to eliminated from the country. Similarly Schistosomiasis had become rare in the regions surrounding Syria.

(An infection caused by exposure to water sources containing a Schistosoma parasite which grows into a worm that resides in different body parts depending on its species, it cans cause fever chills, diarrhoea and can affect urination.)

Furthermore there is worry that there will be more fatal MERS virus cases due to the weakened condition of the refugees.

(Middle East Respiratory Syndrome was first reported in 2012 in Saudi Arabia, not much is known about the virus, however it is known to be a coronavirus meaning they have distinct “crown- like spikes on their surface. Coronaviruses are common viruses that most people get some time in their life that cause mild to moderate upper-respiratory tract illnesses”¹)

Within Syria, farmers have stopped vaccinating their livestock, but have not stopped exporting them. As a result reports of rabies, bovine TB and other such diseases have already emerged from the produce recipients.

As seen as 8/09/13

http://www.cdc.gov/coronavirus/ http://www.cdc.gov/coronavirus/about/index.htm¹

http://www.nlm.nih.gov/medlineplus/tuberculosis.html

http://www.nlm.nih.gov/medlineplus/hepatitis.html

http://www.nlm.nih.gov/medlineplus/leishmaniasis.html

http://www.nlm.nih.gov/medlineplus/ency/article/001321.htm

http://www.newscientist.com/article/dn24157-threatwatch-syrian-refugee-flood-brings-many-dangers.html#.Uit3WmQpZqs, Syrian refugee flood brings many dangers, 05 September 2013, D.MacKenzie

Profitable Healing

According to NHS figures more than 4,400 lives can be saved each year if healthcare standards at hospitals were the same during nights and on weekends as during the working day. As a result the NHS is making “24/7 care” a priority.

In response to this Dr Mark Porter, leader of the British Medical Association (BMA), said

‘But the calls we sometimes hear for a Tesco NHS, full service, 24/7, are just ridiculous.’

Reasons given as to why the concept was labelled as ludicrous included the fact that the NHS simply couldn’t afford it. Unlike Tesco, by functioning ‘comprehensively’ 24/7, the NHS would not make any profit.

A survey carried out by the BMA showed that doctors stated ‘financial constraints’ as one of the main barriers they faced when trying to implement changes, alongside shortage of time and excess bureaucracy.

I went and discussed this idea of full-time care with my aunt who is a nurse, living in London. She told me that she supported the notion of 24/7 care and as healthcare professional she wanted nothing more than to provide the highest standard of care for her patients. I then asked her, as a mother of three young children, how if implemented, the new plan would upset her family and social life and whether the implications would cause others to oppose it. After all if the doctors and nurses were unhappy, their productivity levels would decrease which could have adverse implications on the health care.

She told me that “people are always willing to work” and at the end of the day it all came down to affordability.

- http://www.bbc.co.uk/news/health-23031333 as seen on 1/09/13, 'Tesco-style NHS plan 'ridiculous'", Nick Triggle

Approved Abortion

I just finished reading an interview of Lisa Harris, an assistant professor of obstetrics and gynaecology at the University of Michigan. In the interview, she expressed her thoughts on abortion and which were quite enlightening as they emphasised the doctor's perspective.

The ethics of abortion was brought back into the media spotlight after the unfortunate death of Savita Halappanavar, an Irish dentist originally born in India. My heart goes out to her husband, who lost not one but two members of his family. Savita was pregnant when she found out that her had septicaemia, bacterial infection of the blood. Septicaemia can bring about acute respiratory distress syndrome (ARDS) which reduces the amount of oxygen reaching the lungs and blood. Septicaemia can also lead to septic shocks. Here the infection causes the blood pressure to decrease significantly. Both of the above conditions can lead to death. Savita's body just couldn't handle the fighting the disease and harbouring the foetus. She was miscarrying and was denied an earlier termination. Which was seem to be, regrettably, the cause of her death on the 28th of october.

Abortion in Ireland is illegal. The doctors of Hospital had to wait for the foetus' heart to stop beating before they could perform an uterine evacuation. If the foetus was aborted earlier, there is a high chance that Savita could still be alive. As a result, Irish Abortion laws are coming back into scrutiny.

The predominant argument against abortion that is is morally wrong to 'kill' something that has the potential to possess life. However, Lisa Harris brings up the fact that pro-abortionist, stereotypically labeled as heartless or cold, have just as big a conscience as those against abortion.   Lives can be saved through the performance of septic abortions or other abortions that are needed due to medical complications. Legal abortions can prevent the deaths that occur as a result of 'underground' abortions carried out by under-qualified personnel. In conclusion the choice of abortion can be moral.

- "I wondered if the doctors who initially saw her felt morally compromised by the policy of their hospital" - Lisa Harris

http://www.nlm.nih.gov/medlineplus/ency/article/001355.htm
http://www.nlm.nih.gov/medlineplus/ency/article/000103.htm
http://www.nlm.nih.gov/medlineplus/ency/article/000668.htm
http://www.bbc.co.uk/news/world-europe-20461937
New Scientist Magazine ( Our Distant Origin Issue - 24/11/12)

Curing Cancer

Pink day is a huge event at my school. We love thinking up crazy outfits and baking cupcakes. Apart from raising awareness for breast cancer we also generate quite a substantial amount of money that we donate to support the search for a cure for cancer. However, we never hear about how exactly the money is being used. What progress is being made? Well, if you’ve ever wondered about this the information below should be quite enlightening and re-instil that hope within you in the slight chance you’ve lost it.

CANCER TIMELINE

Past – Although chemotherapy seems quite modern, it was first used in its rudimentary form 70 years ago. The patient receives drugs either orally or via injection. The drug kills by poisoning any fast dividing cells. However this results in both the deterioration of cancerous cells as well as healthy cells such as hair and blood. Other forms of treatment include removing the tumour surgically and destroying cancerous using radiation beams.

Now – Latest forms of treatment aim to reduce side effects, they are called ‘targeted therapies.’ They exploit the molecular pathways - steps through which cells acquire their cancerous behaviour- that function in nearly only in cancer cells and thus decrease the collateral damage inflicted by other treatments. However this method isn’t all that it is made out to be as cancer cells are able to bypass pathways. A patient’s life is at the most increased by a couple of months. 

Future –

1. RNA INTERFERENCE:

-        10 years ago it was discovered that short strands of RNA have the ability to turn on and off specific genes. This is relevant as some genes control cancer growth.

-        Problems currently being encountered include the fact that body cells are able to efficiently detect and destroy these strands which they recognise to be viruses.

-        One solution to this involves hiding these RNA chains in lipid nanomolecules.

2. NANOPARTICLES

- These particles are able to improve the effectiveness and decrease the side effects of existing chemotherapeutic drugs.

- Nanoparticles tend to accumulate in tumours. The bloods vessels are particularly leaky here, and so large amounts of the particles are able to ‘escape’.

- Currently some drugs are already being delivered by nanoparticles. Work is now being done on attaching these small drugs particles to antibodies that attack cancer protein.

3. VIROTHERAPY

- The effect of viruses on our body can be summarised as follows: they infect our cells, force these cells to make virus replicas, these replicas are released and go on to infect more cells where the virus multiplies once again.

- This characteristic can be harnessed, except instead of infection, anti-cancer drugs spread.

- 10 viruses have been genetically modified to infect just tumour cells. The most promising results have been seen with a herpes virus that delivers a powerful immune chemical

4. SUPERBUGS

- It has been found that bacteria including as salmonella and E. coli, both of which are found in the human intestine, take shelter from the immune system in the middle of tumours.

- Similar to the concept of virotherapy, these bacteria can be manipulated so that they carry out actions (eg. Secrete toxins) that will treat cancer.

- Unlike viruses, bacteria are easier to mass produce, manipulate and are able to attack stroma (non cancerous cells that surround and make up nearly 80% of a tumour).

5. IMMUNOTHERAPY

- In 1890s New York Surgeon William Coley saw that a patient’s neck cancer disappeared after developing a nasty skin cells. Since then, we have learnt that our immune systems do keep a watch for cancerous cells and it can be used to kill cancer cells that weren’t destroyed in the first place.

a) A ‘cancer vaccine’ is being looked into. First a preventive vaccine was tested. It contained dead cancer cells or cancer protein as well as chemicals that stimulate the immune system. This failed as the immune cells that destroy the cancer were being sent away by signals emitted by the tumours. Now a more therapeutic approach is being explored. One way the immune cells seem to be provoked is by the injection of genes that code for cancer protein into the body. The cells in the immediate location of the vaccine, are forced to produce the protein until it coats the surface of other cells, attracted the attention of these elusive immune cells. This falls under gene therapy.

b) Another method involves the extraction of immune cells from a cancer a sufferer, manipulating them (eg. ‘culturing them with cancer proteins’) and then reintroducing them to that patients body. This process however is highly individualistic and specific and therefore, unsurprisingly, extremely expensive.

c) T-cells (lymphocytes) that are the actual cancer assassins have also been subjected to cancer protein, then cultured and re-injected into patients. More complexly, attempts are being made at genetically engineering T-cells to attack cancer. This can be achieved by introducing a gene that codes for a receptor that recognises cancer protein. Once again, there is the combination of gene and immunotherapy.

After all this, I find the future to be quite bright. I’m personally intrigued to see how the gene therapy pans out. What are your thoughts? What do you think might be the cure?

- New Scientist (13/10/12 Surprise Theory of Everything Issue)