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By James Gallagher Health and science reporter, BBC News
 
Woman sneezing in a field of flowers
 
Sneezing through summer with a runny nose could become a thing of the past if researchers in London are successful at developing a new hay fever vaccine.

The researchers, at Imperial College London and King's College London, say their "targeted" approach could lead to a cheaper and more effective vaccine.
In tests, they have injected into a layer of skin on patients they think is a "hotline" to the immune system.
Allergy UK said it was a very exciting development.
Treatment for hay fever is largely through drugs such as antihistamines or steroids. In very severe cases, tablets or injections of pollen under the skin can be given. The doses are gradually increased over three years to boost tolerance to pollen. However, the treatment is expensive.
The research team are trying much shallower injections into a part of the skin packed with white blood cells, part of the immune system. They argue their targeted approach means they can use tiny amounts of pollen - their dose is 2,000 times smaller than current injections - and also need fewer injections.
"It is a totally different route," Dr Stephen Till told the BBC. "The injections are very, very superficial almost flat against the skin."
Improvement The results of early tests on 30 patients, published in Journal of Allergy and Clinical Immunology, suggested the allergic reaction to grass pollen decreased with the vaccine.
A third of the patients were given six injections a fortnight apart. Initially the injection resulted in a large lump on the skin, but over time the size of the lump decreased.
The researchers said this suggested the allergic reaction to grass pollen was being switched off.
They are now starting a clinical trial with 90 patients to see if the vaccine can also reduce other symptoms such as sneezing.
Advertisement
Patrick Sachon explains how the Met Office counts pollen from the roof and labs of King's College London

Dr Till said: "If this approach proves to be effective it would define a new scientific and clinical principle that could also be applied to other allergic diseases such as asthma and food allergies.
"This could be a pivotal study in immunological research."
Maureen Jenkins, the director of clinical services at the charity Allergy UK, said this was a "very exciting development" which "offers hope for sufferers".
She added: "The proposed vaccine, if successful, is much quicker and more straightforward than current immunotherapy treatment for hay fever, which takes years. It also has the potential to offer cost savings.
"If this series of injections proves effective in combating hay fever, it will be a wonderful step forward in tackling this common, but often underestimated allergy."
A separate vaccine would have to be developed to help people with allergies to tree pollen.
 
By James Gallagher Health and science reporter, BBC News

Blood sugar test  
Scientists are trying to find out why some ethnic groups much more likely to develop diabetes
 
British people of South Asian, African or African Caribbean descent are significantly more likely to develop Type 2 diabetes than their European counterparts, researchers have warned. 

Half had developed the disease by the age of 80 in a study of 4,200 people living in London - approximately twice the figure for Europeans.
The researchers said the rates were "astonishingly high".
The findings were published in the journal Diabetes Care.
Losing control of blood sugar levels increases the risk of heart disease, stroke, kidney failure, blindness and amputations. Type 2 diabetes is often linked to lifestyle and diet.
Some ethnic groups are already known to have a higher risk of Type 2 diabetes. However, one of the researchers at Imperial College London, Dr Therese Tillin, said it may be down to them simply getting the disease earlier in their lives and the figures would even out over time.
But the study showed: "The rates don't slow down as you get older. The astonishing difference continues," Dr Tillin said.

She warned this could be a sign of things to come with the potential for soaring levels of diabetes around the world as more people lived in cities and enjoyed a calorie-rich diet.
Mystery The scientists involved said that fat, particularly around the waist, could explain some, but not all of the difference, between the ethnicities.
Fellow researcher, Dr Nish Chaturvedi, said genetics could not explain the difference either as there were similar levels of "risky genes" across all groups.
She said: "There is something else that puts them at higher risk and we're not sure what that is."
Dr Mike Knapton, from the British Heart Foundation and a GP, said: "Awareness is really low considering the magnitude of the problem, even I'm surprised by the figures."
He also warned that failing to deal with diabetes would have huge financial consequences for the NHS.
The director of research at Diabetes UK, Dr Iain Frame, said it was "even more important" for people at high risk to manage their weight.
He said: "People from these communities should be screened earlier than the general population - from the age of 25 rather than 40.
"People need to know their risk of developing Type 2 diabetes and get diagnosed as early as possible. We know that people from South Asian backgrounds can often be living with the condition for around 10 years before they are diagnosed, which increases the risk of complications such as heart disease, stroke, kidney failure, blindness and amputation.

Source: BBC news health
 
The towers of the World Trade Center pour out smoke shortly after 
being struck by hijacked airliners in New York in this 11 September 2001
 file photograph 
 
The US federal government has added about 50 types of cancer to the list of illnesses to be covered by a 9/11 health treatment programme.

The decision entitles 70,000 surviving emergency service workers and other survivors to free care.
The National Institute for Occupational Safety announced the change on the eve of the attacks' 11th anniversary.
Some 1,000 deaths have been linked to illnesses caused by toxic dust issuing from wreckage at Ground Zero.
 
Construction workers, emergency workers, office cleaners and others all fell ill in the decade after the attacks.
The institute said last June that it was in favour of expanding the existing $4.3bn 9/11 health programme to include people with 50 types of cancer, following a recommendation from an advisory committee.
Cancers to be covered include lung, colorectal, breast, bladder, leukaemia, melanoma and all childhood cancers.
The medical coverage comes under the Zadroga 9/11 Health and Compensation Act, which was signed into law by President Barack Obama last year.
Until now, most of the health compensation was for respiratory diseases linked to the toxic dust and fumes from the fallen towers.
John Howard, administrator of the World Trade Center Health Program established by the Zadroga law, said Monday's announcement marked "an important step in the effort to provide needed treatment and care to 9/11 responders and survivors".
New York City Mayor Michael Bloomberg said in a statement the decision would "continue to ensure that those who have become ill due to the heinous attacks on 9/11 get the medical care they need and deserve".
The compensation has been held up by a dispute over whether there was evidence of a direct link between the World Trade Center tragedy and cancer.

Source: BBC news US & CANADA
stroke 
Parts of the brain die when clots stop blood delivering oxygen



Using small nets to extract blood clots from patients' brains may be the future of stroke care, according to two studies.

Clots block blood vessels, starving parts of the brain of oxygen, which leads to symptoms such as paralysis and loss of speech.
Two studies, presented in the Lancet medical journal, suggest extracting clots with nets could improve recovery.
The Stroke Association said it was very excited by the treatment's potential.
There are already techniques for reopening blocked blood vessels in people's brains.
Some patients will be given "clot-busting" drugs, but this needs to be in the hours just after the stroke and is not suitable for everyone.

Clot extraction
 
Other techniques have been developed to extract the clot. Some procedures pass a tube up through the groin to the brain. There the wire passes through the clot, forming a coil on the far side and then pulling the clot out. However, this is far from routine practice.
The latest methods involve a tiny wire cage instead of a coil. This pushes the clot up against the walls of the artery and enmeshes the clot in the wires, allowing doctors to pull the clot back out of the groin.
Two similar devices were compared with the current coil methods. One trial of 113 patients showed 58% had good brain function after three months, compared with 33% of those treated with the coil method, as well as a lower death rate.
Another study in 178 patients showed almost double the chance of living independently after treatment.
One of the researchers involved, Prof Jeffrey Saver from the University of California, Los Angeles, told the BBC that these techniques would become more common, as they are more likely to clear clots than drugs.
"Clot-busting drugs only partially reopen 40% of large blocked arteries. These devices partially reopen 70-90% of large blocked arteries.
"Second, these devices can be used in patients in whom it is not safe to give 'clot busting' drugs, such as patients taking anticoagulant medications, patients who had recent surgery, and patients who are between 4.5 to eight hours after stroke onset."
In the long term he can see drugs being used as a first option and then clot removal if the drugs fail or cannot be used.

'Major steps forward'
 
Responding to the research, the Stoke Association's Dr Clare Walton said clot-busters did not work for all patients so new techniques could help many patients.
She added: "Clot retrieval devices have the potential to be used with more stroke patients and are better at removing blood clots than clot-busting drugs.
"We are very excited about this potential new treatment and look forward to further developments."
Dr Philip Gorelick, from Michigan State University, said the studies were "major steps forward in the successful treatment of acute ischaemic stroke, and pave the way for new treatment options".
The research was published to coincide with a European Society of Cardiology meeting in Munich.
By James Gallagher Health and science reporter

Giving antibiotics to young babies may increase their weight later in life, according to US researchers.

A study of 11,532 infants, published in the International Journal of Obesity, showed children under six months who were given antibiotics were heavier in later years.
Researchers say the drugs could be affecting bacteria in the gut, leading to weight changes.
However, they say more work is needed to confirm there is a link.
Bacteria living on people greatly outnumber the body's own cells and there is a growing interest in how this "microbiome" affects human health. In extreme circumstances there are even examples of doctors transplanting faecal matter in order to introduce healthy bacteria into the gut, treating infections when other methods have failed.
'Kill off bacteria' In this study, children who had antibiotics between birth and the age of five months were slightly heavier between the age of 10 and 20 months. After 38 months they were 22% more likely to be overweight.
One of the researchers, Dr Leonardo Trasande from New York University School of Medicine, said: "We typically consider obesity an epidemic grounded in unhealthy diet and exercise, yet increasingly studies suggest it's more complicated.
"Microbes in our intestines may play critical roles in how we absorb calories, and exposure to antibiotics, especially early in life, may kill off healthy bacteria that influence how we absorb nutrients into our bodies, and would otherwise keep us lean."
Microbiologist Dr Cormac Gahan, from University College Cork, said there was certainly a lot of interest in the area, "but it is very early stages for this type of work".
He said changing gut bacteria could alter weight by "a direct effect on energy extraction" or by "influencing hormones".
By Anna-Marie Lever Health reporter, BBC News


A pioneering operation in Leicester to fit a nerve-stimulating implant in a patient with heart failure has been successful.

Similar to a pacemaker, it was fitted to the vagus nerve, part of the nervous system running between the heart and brain down the right side of the neck.
Researchers hope this will cut the stress on the heart, reducing swelling and improving quality of life.
It has been trialled in 32 European patients, but not in the UK before.
Similar nerve-simulating implants have been trialled in Bristol and Liverpool - but this one is more specific - only targeting signals that go to the heart, and not those that go from the heart to the brain.

Prof Jeremy Pearson, from the British Heart Foundation said: "Heart failure affects more than 750,000 people in the UK alone and we need new ways to tackle this often debilitating condition.
"This new procedure could help patients who are responding poorly to current treatment.
Enlarged heart "This is the first large trial to test if the treatment really works and we look forward to seeing the results, which may help thousands of people."
Heart failure can be the result of high blood pressure, dead heart muscle after a heart attack, or a genetic condition.
The heart pumps blood around the body, and when it fails to do this properly people can become tired and out of breath far more quickly. For some patients, sitting in an armchair feels like running a marathon.
Clinical trial As the heart loses its ability to pump, it fills with too much blood and becomes stretched over time. The more the heart enlarges, the worse the symptoms.
Dr Andre Ng, the cardiologist who performed the procedure at Glenfield Hospital, said: "The operation went very well. This is a potentially ground-breaking treatment for desperate patients with heart failure, a serious condition that has increased over the past years in epidemic proportions.
"My University of Leicester research group has been studying the relationship between vagus nerve stimulation and heart function for almost 15 years.
"[This study] could transform heart failure treatment and support the use of the innovative therapy over and above tablets for standard heart failure treatment."
The technique is being trialled in humans after it was shown to keep rats and dogs alive for longer.
Patients who have taken part in the pilot clinical study so far have seen improvements in heart function, resting heart rate and quality of life.
The study will eventually involve more than 600 patients in up to 80 centres worldwide.

Scientists say the discovery of an internal "brush" that helps clear lungs of unwanted matter could help them understand more about lung diseases.

A team from the University of North Carolina found that the brush-like layer pushes out sticky mucus and the foreign bodies it contains.
Writing in Science, it says that could help identify what goes wrong in cystic fibrosis, asthma and similar diseases.
UK lung experts said the work aided understanding of how lungs function.
The mucus, which helps collect inhaled pollutants, emerges as a runny nose and a wet cough.
Until now, most experts believed a watery substance acted as a lubricant and helped separate mucus from the cells lining airways.
But this did not tally with the fact that mucus remained in its own distinct layer.
The researchers used imaging techniques to examine what was happening within the lungs.
They were able to see a dense meshwork of human bronchial epithelial cell cultures.
The brush-like layer consists of protective molecules that keep sticky mucus from reaching the cilia and epithelial cells, thus ensuring the normal flow of mucus.

'Flood' risk

Dr Michael Rubinstein, who led the study, said: "The air we breathe isn't exactly clean, and we take in many dangerous elements with every breath.
"We need a mechanism to remove all the junk we breathe in, and the way it's done is with a very sticky gel, called mucus, that catches these particles and removes them with the help of tiny cilia."
"The cilia are constantly beating, even while we sleep.

"In a co-ordinated fashion, they push mucus, containing foreign objects, out of the lungs, and we either swallow it or spit it out.
"These cilia even beat for a few hours after we die. If they stopped, we'd be flooded with mucus that provides a fertile breeding ground for bacteria."
The team says the brush layer protects cells from the sticky mucus and acts as a "second barrier" in case viruses or bacteria penetrate the mucus.
But in conditions such as cystic fibrosis or chronic obstructive pulmonary disease (COPD), the "brush" fails to work properly, they suggest, becoming squashed and trapping mucus, which then becomes stuck to cells.
Dr Rubenstein said: "The collapse of this brush is what can lead to immobile mucus and result in infection, inflammation and eventually the destruction of lung tissue and the loss of lung function."
He said the findings should help inform new research into such lung conditions.
Prof Stephen Spiro, vice-chairman of the British Lung Foundation, said: "Mucus has a complex biological make-up and forms a vital part of the lungs' defence mechanism against potentially harmful or irritating substances, which are inhaled as small particles.
"Research such as this helps our understanding [of] how this system works, and of the complex mechanisms deep within our lungs which protect us from the atmosphere we breathe in."


                             Carrying excess weight may impact on mental performance experts believe
Being overweight is not just bad for waistlines but for brains too, say researchers who have linked obesity to declining mental performance.
 
 Experts are not sure why this might be, but say metabolic changes such as high blood sugar and raised cholesterol are likely to be involved.

Obesity has already been tipped as a risk factor for dementia.

The work, published in Neurology, tracked the health of more than 6,000 British people over a decade.

The participants, who were aged between 35 and 55, took tests on memory and other cognitive skills three times over a 10-year period.

People who were both obese and who had unhealthy metabolic changes showed a much faster decline on their cognitive test scores compared to others in the study.
Delving deeper

The experts stress that they only looked at cognitive function, not dementia.

The boundary between normal ageing, mild cognitive impairment and dementia is blurred - not all impairment leads to dementia.

All of the study participants came from one group of civil service workers, which may mean the findings may not apply more generally to other populations.

They said: "More research is needed to look at the effects of genetic factors and also to take into account how long people have been obese and how long they have had these metabolic risk factors and also to look at cognitive test scores spanning adulthood to give us a better understanding of the link between obesity and cognitive function, such as thinking, reasoning and memory."

Shirley Cramer of the Alzheimer's Research UK said: "We do not yet know why obesity and metabolic abnormality are linked to poorer brain performance, but with obesity levels on the rise, it will be important to delve a little deeper into this association.

"While the study itself focuses on cognitive decline, previous research suggests that a healthy diet, regular exercise, not smoking and controlling blood pressure and cholesterol in midlife can also help stave off dementia. With dementia figures spiralling towards a million, the findings suggest we should be conscious of our general health throughout life."


































































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