Apollo Health Blog
As Reported On bbc.co.uk
A woman has won a legal battle to stop her dead husband’s frozen sperm being destroyed.
Beth Warren’s husband had sperm frozen before starting cancer treatment and signed paperwork saying his wife could use the sperm after his death.
He died from a brain tumour two years ago, but regulations meant his sperm were due to be destroyed in April 2015.
The High Court has backed her case, but the regulator has already announced plans to appeal against the decision.
I am elated. Every good word in the dictionary. I hadn’t dared to let myself believe it would happen”
The couple, who were together for eight years, married in a hospice six weeks before his death and she subsequently changed her surname to Warren.
The law allows sperm and eggs to be stored for up to 55 years, if consent is regularly renewed.
But when 32-year-old Warren Brewer, a ski instructor, died of a brain tumour in February 2012, consent could no longer be renewed.
The regulators, the Human Fertilisation and Embryology Authority (HFEA), said the sperm could not be stored beyond April 2015.
But lawyers representing Mrs Warren, 28, from Birmingham, told the High Court judge that the regulator was taking an “excessively linguistic and technical approach”.
In her judgement, Mrs Justice Hogg said: “The evidence indicates that both Mr Brewer and his wife were in agreement. He wanted her to have the opportunity to have his child, if she wanted, after his death.”
The judgment may have implications for other cases in which the sperm provider’s wishes are less clear.”
The Human Fertilisation and Embryology Authority (HFEA)
But, she continued, the “written consents provided by Mr Brewer did not specify that his gametes should be stored beyond the statutory period” required by the HFEA.
She ruled that it was “right and proper, and proportionate” to allow the sperm to be kept until at least April 2023.
Mrs Warren said she was “over the moon” and “elated” with the decision.
She told the BBC: “It’s beyond words, I hadn’t even anticipated that I would feel that happy about it.
“I hadn’t let myself believe I would get that outcome because I knew it really could have gone either way.”
Her brother died in a car accident just weeks before her husband died.
She said that at that emotional time a forced deadline was not the reason to have a child and that she needed the time to “establish myself emotionally, financially and professionally” before choosing to have a child.
Looking purely at the letter of the law, Beth Warren did not seem to have a strong case.
But in her ruling Mrs Justice Hogg decided to overrule the regulations and look at what had been the intentions of the couple.
At every stage Mr Warren had made clear that his partner, and later wife, should be allowed to use his sperm in the event of his death.
The fundamental problem was the couple had not been given the opportunity by their fertility clinic to store his sperm for a prolonged period.
The judge said this produced “a great and conspicuous unfairness”.
She was satisfied that – had he been informed, Mr Brewer would have consented to it being stored for up to 55 years.
The judge said that to destroy Mr Warren’s frozen sperm would be contrary to his wishes and a “devastating loss” to his widow in the event of her wishing to bear his child.
The judge also upheld Beth Warren’s claim under the Human Rights Act.
Her lawyers argued successfully that destroying the sperm would breach her rights under Article 8 – respect for private and family life.
Judgments like this might have implications for future cases, but the judge said these are likely to be relatively few.
Mrs Warren said she had not decided what she would do now, as she had not let herself believe she could win.
At the start of the legal bid, Mrs Warren said it would be a “huge decision” to have a child who would never meet their father.
She added: “I cannot make that choice now and need more time to build my life back.
“I may never go ahead with treatment but I want to have the freedom to decide once I am no longer grieving.”
However, this is not the end of the legal battle as the HFEA has asked for leave to appeal against the decision.
In a statement, the authority said: “We had hoped that the court could find a way for Mrs Warren to store the sperm for longer without having wider implications for the existing consent regime.
“However, because the judgment acknowledges that written consent to store the sperm beyond April 2015 is not in place, the judgment may have implications for other cases in which the sperm provider’s wishes are less clear.”
Mrs Warren’s lawyer, James Lawford Davies, had said the regulations created injustice.
“Common-sense dictates that she should be allowed time to recover from the loss of her husband and brother and not be forced into making such an important reproductive choice at this point in her life.”
He also said the regulations created inconsistencies.
There are no restrictions on exporting the sperm so they could be used in fertility treatment in another country.
The sperm could also be used to create embryos, which could be frozen and stored for seven years.
As Reported On bbc.co.uk
Doctors have used gene therapy to upgrade the immune system of 12 patients with HIV to help shield them from the virus’s onslaught.
It raises the prospect of patients no longer needing to take daily medication to control their infection.
The patients’ white blood cells were taken out of the body, given HIV resistance and then injected back in.
The small study, published in the New England Journal of Medicine, suggested the technique was safe.
Some people are born with a very rare mutation that protects them from HIV.
This is a fascinating study and a significant development in tackling HIV.
But let’s be clear – this is not going to be a routine treatment any time soon.
Currently excellent drugs keep the virus in check, but if treatment stops then HIV runs rampant again.
Genetically modifying the immune system so that it can resist HIV’s attacks could eventually free people from medication.
However, for now this is just an early test and there will be questions about safety, cost and effectiveness as this treatment is developed.
But add this finding to the vaccine trials taking place and the HIV baby ‘cures’ stories and there is a growing sense that a significant turning point for HIV is on the horizon.
It changes the structure of their T-cells, a part of the immune system, so that the virus cannot get inside and multiply.
The first person to recover from HIV, Timothy Ray Brown, had his immune system wiped out during leukaemia treatment and then replaced with a bone marrow transplant from someone with the mutation.
Now researchers at the University of Pennsylvania are adapting patients’ own immune systems to give them that same defence.
Millions of T-cells were taken from the blood and grown in the laboratory until the doctors had billions of cells to play with.
The team then edited the DNA inside the T-cells to give them the shielding mutation – known as CCR5-delta-32.
About 10 billion cells were then infused back in, although only around 20% were successfully modified.
When patients were taken off their medication for four weeks, the number of unprotected T-cells still in the body fell dramatically, whereas the modified T-cells seemed to be protected and could still be found in the blood several months later.
The trial was designed to test only the safety and feasibility of the method, not whether it could replace drug treatment in the long term.
Prof Bruce Levine, the director of the Clinical Cell and Vaccine Production Facility at the University of Pennsylvania, told the BBC: “This is a first – gene editing has not to date been used in a human trial [for HIV].
“We’ve been able to use this technology in HIV and show it is safe and feasible, so it is an evolution in the treatment of HIV from daily antiretroviral therapy.”
He says the aim is to develop a therapy that gets people away from expensive daily medication.
The idea of modifying a T-cell to make it resistant and showing it is feasible and they survive – that’s exciting in itself”
Prof Sharon LewinMonash University
“What if we can now take the leap to an upfront treatment that can last for years?”
Such a treatment will be expensive so any benefit will depend on how long people could be freed from drugs and how long that protection would last.
Prof Levine argues this could be several years, which might save money in the long term.
Commenting on the findings, Prof Sharon Lewin from Monash University in Australia, told BBC News: “The idea of modifying a T-cell to make it resistant and showing it is feasible and they survive – that’s exciting in itself.
“What most people are aiming for in HIV is a way you take treatment for a short period of time and that keeps the virus under control.”
She said drug treatment would not be replaced by this, especially in the early stages of the infection.
But it might lead to people eventually replacing drugs with an immune upgrade, but “it’s still a long way off”.
Oxygen is very essential for the visual cells in our eyes. It’s like fuel to a car ! The retina which is responsible for the first stages of the visual process has a limited blood supply, so there’s a delicate balance between the high oxygen demand of our retinal cells and a limited supply. Oxygen is the most supply-limited substance in the human retina. When a slight imbalance occurs in the eye due to a lack of oxygen, our retina is stressed and this can lead to various eye diseases.
As Reported On bbc.co.uk
The number of Syrian children in need has more than doubled in the past year to 5.5 million, the United Nations Children’s Fund (Unicef) says.
Up to a million are living under siege and in areas that the agency and other humanitarian organisations cannot access, according to a new report.
Children in Syria have lost “lives and limbs, along with virtually every aspect of their childhood”, it warns.
UN figures say more than 10,000 have been killed in three years of conflict.
However, the report notes that real number is probably higher.
This third devastating year for Syrian children must be the last”
Anthony LakeExecutive Director, Unicef
The statistics presented in Unicef’s report, Under Siege – the devastating impact on children of three years of conflict in Syria, are daunting.
Up to a million children live in areas which are either under siege or very hard for relief agencies to reach, while around three million have had their education completely disrupted.
More than three million been displaced inside Syria – a threefold increase in the space of a year – and 1.2 million – more than half the total number – have become refugees abroad, up from 260,000. Some 425,000 refugees are under five.
In addition, many children have had to start working early and very young girls have been forced to marry for financial reasons. Boys as young as 12 have been recruited to support the fighting.
Around two million children are said to need counselling for trauma.
The Unicef report warns the situation is likely to get worse.
“Cut off from aid, living in rubble and struggling to find food, many Syrian children have been left without protection, medical care or psychological support, and have little or no access to education,” it says.
“In the very worst cases children and pregnant women have been deliberately wounded or killed by snipers.”
Unicef says it has only been able to raise 8% of the funding it says it needs to do its job properly.
“This war has to end so that children can return to their homes to rebuild their lives in safety with their family and friends. This third devastating year for Syrian children must be the last,” said Unicef’s executive director, Anthony Lake.
As Reported On bbc.co.uk
A Japanese scientist behind a seemingly groundbreaking stem cell study says the findings should be withdrawn amid doubts over its quality.
It was reported in January that dipping cells in acid could cheaply and quickly convert them into stem cells.
But questions were raised about the images used in the scientific report and other research groups have failed to reproduce the results.
Author Prof Teruhiko Wakayama said: “It is no longer clear what is right.”
The future of regenerative medicine is pinned on stem cells, which can transform into any other type of tissue. They are being investigated for restoring sight to the blind and repairing the damage caused by a heart attack.
‘Mistakes have emerged’
The original study, published in the journal Nature, became a huge story around the world and was described as “remarkable” and as a “major scientific discovery”.
It said stem cells no longer needed to be taken from embryos or made by complicated and costly genetic tinkering.
Instead, shocking skin cells with acid could drive them back into a stem cell state.
The breakthrough findings have not been discredited, but they have come under intense scrutiny.
The Reuters news agency reports Prof Wakayama, of the University of Yamanashi, told Japanese TV: “When conducting the experiment, I believed it was absolutely right.
“But now that many mistakes have emerged, I think it is best to withdraw the research paper once and, using correct data and correct pictures, to prove once again the paper is right.
“If it turns out to be wrong, we would need to make it clear why a thing like this happened.”
On the day the findings were announced, Dr Haruko Obokata explained how she nearly gave up on the project when fellow researchers did not believe what she had found
As Reported On bbc.co.uk
Even moderate drinking during the earliest months of pregnancy may be damaging, say researchers in Leeds.
Their study is the latest in a long debate over whether it is safe to drink at all during pregnancy.
The findings, published in the Journal of Epidemiology and Community Health, suggest the chances of premature birth increased.
The NHS recommends people avoid alcohol during pregnancy or when trying to conceive.
But says if people choose to drink, then they should not have more than two units of alcohol (about one pint) twice a week.
Heavy drinking in pregnancy is known to be damaging as it can affect the baby’s development. But there is far more debate about drinking at the upper limit of the NHS guidelines.
Around seven in every 100 births in the UK is premature.
The study on 1,264 women in Leeds showed drinking more than the two units limit doubled the risk of premature birth, but even drinking at the limit increased the risk.
Camilla Nykjaer, one of the researchers at the University of Leeds, told the BBC: “This is a very sensitive issue, we don’t want women who are pregnant now to panic, the individual risk is actually low.
“They shouldn’t drink, they should stop drinking if they have been drinking during the pregnancy.”
However, a study of more than 11,000 five-year-olds, conducted by University College London, showed drinking one or two units of alcohol a week during pregnancy did not raise the risk of developmental problems in the child.
Prof Yvonne Kelly who conducted that research told the BBC: “Heavy drinking is really very, very bad, but at low levels, in the work we’ve done we haven’t found any negative effects in childhood.
“It’s a massively charged area, getting the tone of this right is quite difficult.
“The guidelines are there, women are sentient beings and can choose – it’s hugely politically charged all of this, I guess people will make their own judgements.”
Dr Patrick O’Brien, a spokesperson for the Royal College of Obstetricians and Gynaecologists, said: “While the safest approach would be to choose not to drink at all, small amounts of alcohol, not more than one to two units once or twice a week, have not been shown to be harmful after 12 weeks of pregnancy.
“Pregnant women should always consult their midwives or doctors if they have any concerns about their alcohol intake.”
As Reported On bbc.co.uk
Women who suffer swelling following breast cancer treatment should be encouraged to exercise, say experts.
New National Institute for Health and Care Excellence (NICE) guidance says exercise will not make the problem worse and could improve well-being.
One in five people treated for breast cancer will go on to develop lymphoedema in their arm, hand, fingers or chest.
It is a long-term condition that can lead to pain and loss of mobility.
The new NICE guidance, which is subject to consultation, says doctors and nurses should discuss with patients how exercise may improve their quality of life.
They should also stress that the current evidence shows “exercise does not prevent, cause or worsen lymphoedema”.
Many people with breast cancer go on to develop lymphoedema in their arm or chest following surgical or radiotherapy treatment.
It occurs when the body’s lymphatic system becomes damaged and is unable to drain fluid in the normal way.
Prof Mark Baker, director of the NICE centre for clinical practice, said: “For breast cancer patients, lymphoedema may occur as a result of treatment – such as surgery or radiotherapy – or cancer cells blocking the lymph system.
“Some people may be cautious of taking up exercise as they may think it could make their lymphoedema worse or bring it about in the first place.
“Our proposed new recommendations should clear up any confusion relating to the role that exercise can play for people with or at risk of this condition.”
Jackie Harris, clinical nurse specialist at Breast Cancer Care, said lymphoedema can severely restrict movement and impact lives.
“Lymphoedema can be controlled but will never go away and we know that regular exercise has many benefits for those living with or at risk of lymphoedema,” she said.
“Regular movement in everyday life or work can help keep joints supple and aids lymph drainage and extra exercises can also be useful if swelling restricts movement of the arm.”
As Reported on bbc.co.uk
A survivor of a serious motorbike accident has had pioneering surgery to reconstruct his face using a series of 3D printed parts.
Stephen Power from Cardiff is thought to be one of the first trauma patients in the world to have 3D printing used at every stage of the procedure.
Doctors at Morriston Hospital, Swansea, had to break his cheekbones again before rebuilding his face.
Mr Power said the operation had been “life changing”.
The UK has become one of the world’s pioneers in using 3D technology in surgery, with advances also being made by teams in London and Newcastle.
I can’t remember the accident – I remember five minutes before and then waking up in the hospital a few months later”
While printed implants have previously been used to help correct congenital conditions, this operation used custom printed models, guides, plates and implants to repair impact injuries months after they were sustained.
Despite wearing a crash helmet Mr Power, 29, suffered multiple trauma injuries in an accident in 2012, which left him in hospital for four months.
“I broke both cheek bones, top jaw, my nose and fractured my skull,” he said.
“I can’t remember the accident – I remember five minutes before and then waking up in the hospital a few months later.”
In order to try and restore the symmetry of his face, the surgical team used CT scans to create and print a symmetrical 3D model of Mr Power’s skull, followed by cutting guides and plates printed to match.
Maxillofacial surgeon Adrian Sugar says the 3D printing took away the guesswork that can be problematic in reconstructive work.
“I think it’s incomparable – the results are in a different league from anything we’ve done before,” he said.
“What this does it allows us to be much more precise. Everybody now is starting to think in this way – guesswork is not good enough.”
The procedure took eight hours to complete, with the team first having to re-fracture the cheek bones with the cutting guides before remodelling the face.
A medical-grade titanium implant, printed in Belgium, was then used to hold the bones in their new shape.
Looking at the results of the surgery, Mr Power says he feels transformed – with his face now much closer in shape to how it was before the accident.
“It is totally life changing,” he said.
“I could see the difference straight away the day I woke up from the surgery.”
Having used a hat and glasses to mask his injuries before the operation, Mr Power has said he already feels more confident.
“I’m hoping I won’t have to disguise myself – I won’t have to hide away,” he said.
“I’ll be able to do day-to-day things, go and see people, walk in the street, even go to any public areas.”
The project was the work of the Centre of Applied Reconstructive Technologies in Surgery (Cartis), which is a collaboration between the team in Swansea and scientists at Cardiff Metropolitan University.
Design engineer Sean Peel has said the latest advance should encourage greater use of 3D printing within the NHS.
“It tends to be used for individual really complicated cases as it stands – in quite a convoluted, long-winded design process,” he said.
“The next victory will be to get this process and technique used more widely as the costs fall and as the design tools improve.”
Mr Power’s operation is currently being featured in an exhibition at the Science Museum in London, called 3D Printing: The Future.
As Reported On bbc.co.uk
Temporary blindness heightens hearing and has potential as a therapy for some deaf people, animal research suggests.
A study, published in the journal Neuron, showed keeping mice in the dark for a week changed their brains and enhanced hearing.
The effect lasted for several weeks after they were returned to the light.
Experts said it was a “fascinating” finding, but making more permanent brain alterations would be key to any new treatments for hearing loss.
The US team at Johns Hopkins University and the University of Maryland compared the hearing of mice that had been kept in complete darkness for a week with that of others getting natural light.
Those kept in the dark could hear softer sounds and there were changes in the structure of the auditory cortex in the brain.
“It was quite a surprise to us,” said Dr Patrick Kanold, from Maryland.
One thought was that part of the brain being used for vision was being repurposed, but it seemed the sections dedicated to hearing were being beefed-up.
There is a burgeoning science in auditory training and developing ways to learn to listen better, it’s a real hot topic.”
Dr Michael AkeroydMRC Institute of Hearing Research
Dr Kanold told the BBC’s Inside Science Programme: “We are not growing any new neurons we are simply strengthening existing connections in the auditory cortex.”
“This really give us hope that there might be some potential to apply this in humans, the nice thing is we don’t need drugs, so it’s relatively straightforward to test.
“This might have implications in deaf people, there’s a variety of people that receive cochlear implants as an adult and it might be the case that this enhances the success of these cochlear implants.”
It is not certain if the same brain changes would take place in people or if they could reverse the declines associated with old age.
Dr Michael Akeroyd, from the Medical Research Council’s Institute of Hearing Research, in Glasgow, told the BBC: “I thought, ‘Ooh this is interesting.’ I don’t know if it’s practical, but it’s got potential.”
He said putting old people with hearing loss into dark rooms for a week or more was unlikely to happen, but that the study added to a growing awareness that there was more to hearing than just the ear.
“Some of most exciting research is that hearing is not just hearing it’s listening, there is a burgeoning science in auditory training and developing ways to learn to listen better, it’s a real hot topic,” he said.
“I would suggest looking for permanent changes next, if you can make it permanent then you’re onto a winner.”
Dr Ralph Holme, the head of biomedical research at the charity Action on Hearing Loss, said: “This is a fascinating study that tells us more about how our sensory systems interact, in this case how blindness can enhance hearing.
“It is important research because once the mechanisms involved are understood it may be possible to develop training or even pharmacological approaches to boosting these processes to help people with hearing loss.
“More research is now needed to establish if similar findings can be observed in humans and whether or not these changes actually lead to better hearing in the real world.”
As Reported On bbc.co.uk
Global deaths from measles dropped 78% between 2000 and 2012, the World Health Organization estimates.
New figures from the WHO suggest that around 13.8 million deaths were prevented during this time and reported cases declined by 77%.
Good routine immunisation levels and campaigns to vaccinate children are thought to be behind the figures.
But the WHO says measles is still a global threat and some populations remain unprotected.
The mortality estimates from the WHO show that annual measles deaths decreased from more than 562,000 in 2000 to 122,000 in 2012.
Reported cases of measles worldwide declined from 853,480 to 226,722 over the same time.
There is much more work to be done as more than 330 deaths (mainly among children) still occur daily from measles ”
Karen MahThe Measles andRubella Initiative
Currently, 84% of the world’s infants receive the first dose of measles vaccine before their first birthday, according to the WHO.
It says that 145 countries have also introduced a routine second dose of measles vaccine to ensure immunity and prevent outbreaks.
Mass campaigns against measles in 2012 resulted in a further 145 million children being vaccinated against the disease, taking the total number of vaccinated children to more than one billion since 2000.
However, there are still concerns that despite this good news, measles remains a worldwide threat.
The regions of Africa, south-east Asia and Europe all experienced large outbreaks in 2012, and the Americas region had to deal with many imported measles cases.
The Democratic Republic of Congo saw the largest measles outbreak of 2012, with 72,029 reported cases. There were around 18,000 cases in India and 12,000 in Ukraine, while the UK experienced just over 2,000 measles cases.
The WHO says the Africa, Eastern Mediterranean and European regions are not likely to meet their measles elimination targets on time.
Without improved immunisation coverage, outbreaks will continue to occur, it says.
Karen Mah, a spokeswoman for The Measles and Rubella Initiative, a global partnership led by the WHO and UNICEF among others, said there were still too many children dying.
“While estimated measles deaths have dropped significantly since 2000, there is much more work to be done as more than 330 deaths (mainly among children) still occur daily from measles.
“We need to move beyond an 84% global routine immunisation coverage. It’s also vital that parents are fully aware of the benefits of immunisation and the risks associated with not vaccinating children,” she added.
The Measles and Rubella Initiative wants to reduce measles deaths by 95% by 2015 and get rid of measles and rubella in at least five regions of the world by 2020.