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Access To IVF Increases As New Guidance Makes System Fairer
The NHS is taking a step closer to ending regional variation in the provision of IVF to couples who are unable to conceive naturally, Public Health Minister Gillian Merron announced today.
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Over Half Of People With Rheumatoid Arthritis Have Periodontitis
Over half (56%) of people with rheumatoid arthritis (RA) also have periodontitis (a chronic inflammatory disease of the gum and surrounding ligaments and bones that hold the teeth in place), displaying fewer teeth than healthy matched controls, high prevalence of oral sites presenting dental plaque and advanced attachment loss (the extent of periodontal support that has been destroyed around a tooth) (chi square p
News of the day
WHO Stops Tracking H1N1 Cases
"In a move that caught many public health experts by surprise, the WHO quietly announced Thursday that it would stop tracking swine flu cases and deaths around the world," the New York Times reports. According to the newspaper, the announcement "perplexed some experts, and even baffled a WHO spokesman, Gregory Hartl," who "earlier in the day ò€¦ had confirmed Argentina, with 137 swine flu deaths since June, had surpassed Mexico, where the epidemic began in February, as the country with second largest number of swine flu deaths." While the last WHO updated indicated nearly 95,000 people worldwide had been infected with H1N1, "[m]any epidemiologists have pointed out that, in reality, millions of people have had swine flu, usually in a mild form, so the numbers of laboratory-confirmed cases were actually meaningless" while tests "overwhelmed national laboratories," according to the New York Times (McNeil, 7/16).
Public Health

Liver Disease "shrunk" By Blood-pressure Drug

A blood-pressure medicine has been shown to reverse the effects of early-stage liver failure in some patients. Newcastle University researchers analysed a small clinical trial of losartan, a drug normally prescribed for hypertension, on 14 patients in Spain, who had Hepatitis C. The illness was at an advanced stage causing fibrosis - scarring in the liver - which would usually have progressed to liver failure. Half of the patients in the trial saw the scars in their liver shrink allowing the organ to repair itself. Professor Derek Mann from Newcastle University said: "At the moment we have no proven effective way of treating people with chronic liver disease other than transplantation. This early stage trial has shown that we can shrink liver scarring in some patients and shows promise for a treatment that could make a huge difference to the lives of thousands of people." The team whose work is published today in Gastroenterology, say this early stage trial is promising and they now want to carry out several much larger studies initially involving patients with liver disease caused by obesity and then later alcohol, hereditary and autoimmune diseases. Mechanism Liver damage, known as fibrosis, is caused by the unwanted accumulation of excess fibrous connective tissue which is produced and maintained by a specialised cell, the liver myofibroblast. In chronic liver disease a signalling pathway is created that instructs the liver myofibroblast to stay alive and proliferate. It is this pathway that then causes scar tissue to accumulate, creating the liver damage. Work carried out in rat and mouse models allowed the researchers to study what was happening inside the liver when losartan, an angiotensin II receptor antagonist drug, was present. Researchers believe that the drug blocks the signalling pathway so that the liver myofibroblasts die, removing the of scar tissue. As the scar tissue breaks up, the damaged area of the liver is repaired by the body. In this research, funded by the Medical Research Council and the British Liver Trust, the Newcastle University researchers discovered a biological marker, NF-kB, was crucial for the activities of scar-forming cells. Tests on their livers revealed that, before treatment with losartan, half of the patients had a high level of the biomarker NF-kB. After treatment, the level fell indicating that losartan is able to switch off NF-kB with the result that scars are no longer produced or maintained, but instead shrink. Professor Mann said: "By measuring the amount of active NF-kB in the liver from a biopsy sample, we may be able to tell which patients will benefit from treatment with losartan or similar drugs such as ACE inhibitors. This may prove to be a new treatment for up to half of all liver patients." People with liver disease caused by being overweight - through fatty liver disease or NASH (Nonalcoholic Steatohepatitis) - and who are interested in taking part in a future clinical trial should leave their details on tel: 0191 2231900 Academic paper: Angiotensin II activates IkB kinase phosphorylation of Re1A at Ser536 to promote myofibroblast survival and liver fibrosis. Fiona Oakley, Victoria Teoh, Gemma Ching-A-Sue, Ramon Bataller, Jordi Colmenero, Julie R Jonsson, Aristides G Eliopoulos, Martha R Watson, Derek Manas, Derek A Mann. Gastroenterology


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