Thursday December 24 2015
Top five of top fives
As we move towards the end of the year, like all news sources, we fall back on that classic space filler – the list story. So, without further ado, here is the official Behind the Headlines' Top Five of Top Fives stories of 2015, in which we celebrate the good news, worry about the bad, pour scorn on some rubbish reporting and answer some of the burning questions of the year.
The top five 'Reasons to be cheerful'
Health news isn’t all doom, gloom, things that may kill you and things that will definitely kill you. Occasionally, we do get a few nuggets of good news on our news desk. Here are our favourite five of the year:
Pioneering work carried out at Great Ormond Street Hospital made use of a new technique known as genome editing to treat a baby girl, one-year-old Layla Richards, who had acute lymphoblastic leukaemia (ALL). ALL is cancer of the white blood cells.
The outlook for ALL is usually good, with around 85% of children achieving a complete cure. However, this was not the case with Layla, as she failed to respond to conventional treatments. The staff treating Layla at Great Ormond Street Hospital sought permission to try a new technique, previously only used in mice, called genome editing.
Genome editing uses a range of molecular techniques to make changes to the genome (the complete set of DNA) of individual organisms.
In Layla's case, proteins known as Transcription Activator-Like Effector Nucleases (TALENs), were used as a kind of "molecular scissors" to modify the DNA inside a batch of donated T-cells (an immune cell).
The T-cells were modified to seek out and destroy the abnormal leukaemia cells, while also becoming resistant to the chemotherapy drugs Layla was taking.
Layla responded well to the treatment and is now back home with her family.
In June, it was announced that all newborn babies in England and Scotland were to be offered a vaccine to combat meningitis B, as part of the routine NHS childhood vaccination schedule.
Meningitis B is a highly aggressive strain of bacterial meningitis that infects the protective membranes surrounding the brain and spinal cord. It can cause severe brain damage and infect the blood (septicaemia). In some cases, bacterial meningitis can be fatal.
The development of a safe and effective meningitis B vaccine is the culmination of more than 20 years of research and represents a significant breakthrough in disease prevention. The vaccine could help to prevent around 1,300 cases of meningitis B a year in the UK.
This was the world’s first publicly funded vaccination programme for the potentially fatal disease – another first for the NHS!
A study found that the active ingredient in some antifungal creams used to treat athlete’s foot, miconazole, can also help to repair nerve damage in baby mice who were engineered to develop the symptoms of multiple sclerosis.
While the obvious warnings about extrapolating the results of animal studies to humans apply, this research could offer a tantalising prospect of a cure for MS.
With the threat of antibiotic resistance becoming a pressing concern in 2015, it's vital that new types of antibiotics are developed. Thankfully, the work of an international collaboration may have discovered one.
Called teixobactin, the drug works by attacking cell walls, rather than the proteins inside bacteria. This new approach could reduce the risk of bacteria developing resistance to the drug.
We now need to wait for tests on humans to make sure that teixobactin works and is safe.
This is genuinely exciting news, but only time will tell if this is a historical moment of similar magnitude to Alexander Fleming’s original discovery of penicillin in 1928.
More good news on the vaccine front were reports in August that a field trial of an Ebola vaccine proved "100% effective". Researchers gave the Ebola virus vaccine to thousands of people in Guinea who'd had close contact with an infected individual – a process called "ring vaccination". Half the sample were given the vaccine immediately, while the other half were given the vaccine after a delay of three weeks.
The early results, published in The Lancet and publicised by the World Health Organization (WHO), showed the vaccine had 100% effectiveness when given immediately. Nobody developed Ebola symptoms up to 10 days after being given the vaccine immediately after exposure.
It is very early days, but an effective vaccine could lead to the eradication of this deadly disease.
The top five 'Things that make you go 'd’oh'' stories
Of course, with every silver lining comes a cloud, and your glass of champagne can be half empty rather than half full. Here are the top five stories that promoted doom and gloom in our office and left us looking for our secondhand Hazmat suit:
In November, researchers reported that E.coli bacteria from food products in China had developed resistance to colistin – a polymixin antibiotic.
This antibiotic is, in a sense, a weapon of last resort in the antibiotics armoury, and is sometimes used to treat serious infections that have become resistant to other strong antibiotics.
The researchers found that colistin resistance was caused by a gene called MCR-1. This gene was found on a piece of bacterial DNA that can be transferred between bacteria.
They took a number of samples from animals in abattoirs, and raw meat from open markets and supermarkets in China to identify how frequently the MCR-1 gene is found in bacteria.
The study found the MCR-1 gene in E. coli collected from 15% of raw meat samples and 21% of animals tested from 2011-14. The gene was also found in E. coli from 1% of hospital inpatients in China.
As this study was conducted in China, we do not know whether the situation is the same in the UK. However, antibiotic resistance is a global concern that could potentially advance more quickly than new antibiotics can be developed.
We could end up with a situation where doctors are forced to say, "Sorry, there is nothing I can do to cure your infection".
Aside from antibiotics, paracetamol was regarded as one of the wonder drugs of the 20th Century (though it was first introduced in 1886). A safe and effective painkiller that doesn’t carry the risk of blood thinning associated with aspirin. Or so we thought.
Alarming news from March suggested that long-term use of paracetamol was linked with a small increased risk of adverse events such as heart attacks, gastrointestinal bleeds (bleeding inside the digestive system) and impaired kidney function.
While the risk for individuals is small, the fact that paracetamol is used by millions means further investigation is needed.
Could it be bad news for the ladies who enjoy a "wine o'clock" moment at the end of a busy day?
A study from August suggested that women who drank the equivalent of a glass of wine a day over a 30-year period were 13% more likely to develop one of the alcohol-related cancers (breast cancer being the most common) than women who didn't drink at all.
Sugar and spice and all things nice? Apparently not. Data compiled by the health body Public Health England estimated that, arguably due to a sugar-rich diet:
- a fifth of 12- and 15-year-olds (22% and 19% respectively) reported experiencing difficulty eating in the past three months
- more than a third (35%) of 12-year-olds and more than a quarter (28%) of 15-year-olds reported being embarrassed to smile or laugh because of the condition of their teeth
- 58% of 12-year-olds and 45% of 15-year-olds reported that their daily life had been affected by problems with their teeth and mouth in the past three months
There was some good news, however. There were reductions in the extent and severity of tooth decay present in the permanent teeth of 12- and 15-year-olds overall in England.
So bad, but not as bad as it used to be.
Will turning that frown upside down increase your life expectancy? Apparently not, according to a study published in December. The study surveyed more than 700,000 women and found no evidence of a direct cause and effect link between happiness and life expectancy.
Still, on the bright side, being miserable didn’t make people die sooner.
The top five 'Call that reporting?' stories
We look at a lot of health journalism. Some of it excellent, some of it good, some of it downright terrible. Here are our top five examples of the latter:
A single case report sparked a UK media frenzy, which allowed them to indulge in shameless click-baiting by showing photos of various skinny jean-wearing celebs such as Russell Brand, Kate Moss, Harry Styles and the Duchess of Cambridge. By the tone of the reporting, you could assume that hordes of hipsters are having skinny jean-related health problems. In fact, the furore was sparked by just a single case report.
A woman in Australia who, after squatting for a long time while wearing skinny jeans, had severe ankle weakness. She fell over and could not get back up by herself, and ended up having her jeans cut off and staying in hospital for four days until she recovered.
It is thought she developed a condition called compartment syndrome, where pressure in an enclosed bundle of muscles can adversely affect muscle and nerve function. Since the story broke in June, there have been no other reported cases, so we assume that the residents of East London remain safe.
"Drinking three glasses of champagne per week could help stave off dementia and Alzheimer's disease," the Daily Mirror reported in November.
But the study it reported on didn’t actually involve any humans with dementia. Or humans at all, come to that. The study in question was actually published in 2013, but apparently recently went viral on social media. It looked at the possible effects of the phenolic acids found in champagne on memory in rats.
The main finding was that rats given champagne were better at remembering how to find the treat in a maze test than those given an alcohol-free drink. They found the treats roughly five times out of eight, compared with four times out of eight in rats given the other drinks.
With the greatest will in the world, a slightly improved maze performance in a small number of rats does not translate into humans having a reduced risk of dementia from drinking champagne.
In October, the front page of the Daily Express announced that "Rhubarb can save your life" due to the alleged cancer cell-killing properties of parietin: a substance found in rhubarb. As you probably suspect, these claims were unsupported by the facts. Tests were only carried out on cancer cells in the laboratory and in mice.
A much more sensible quote was provided by a spokesperson from Cancer Research UK, who said "Even if it's proven that parietin can treat cancer in people, it's unlikely that anyone could eat enough rhubarb to get the benefits."
In September, the Daily Mirror claimed, "You can catch Alzheimer's", while the Mail Online chipped in that an "explosive new study suggests the disease is spread like CJD [Creutzfeldt-Jakob disease] and could be passed on through blood transfusions, operations and dental work".
Neither claim added up to much scrutiny, as the "explosive" study itself concluded: "There is no suggestion that Alzheimer's disease is a contagious disease and no supportive evidence … that Alzheimer's disease is transmissible, notably by blood transfusion".
The reality was that a small study found that contaminated human growth hormones, which are no longer used, spread CJD to eight people during the 1980s.
"How having just the one drink can make you look more gorgeous, according to science," The Independent reported in March. But the "science" turned out to be an experiment carried out under highly artificial conditions.
The headline came from a small study looking at whether drinking alcohol makes people more physically attractive to others. It found that photographs of those who had consumed a "low-dose" alcoholic drink (a large glass of wine) were rated as more attractive than images of sober individuals.
But photographs of people who went on to have a second drink were not rated as more attractive than those who drank nothing, and the apparent effect of alcohol on perceived attractiveness was only slight.
Alcohol may make you think you are attractive, but the reality could be somewhat different.
The top five 'science is cool' stories
Scientists are cool and the science they practise is even cooler. Here are our five coolest stories of the year:
Cystic fibrosis is a genetic condition caused by a mutated gene called CFTR. The mutation causes the lungs and digestive system to become clogged up with sticky mucus.
The goal of gene therapy for cystic fibrosis is to replace the faulty CFTR gene with a working one.
Previous attempts of using a virus to deliver the working gene proved unsuccessful, as the lungs' defence system against infection stopped the virus from entering.
In July, researchers announced that they had tried a novel approach to get around the problem – encasing the working gene in a bubble of fat, which was then delivered to the lungs via a nebuliser.
When compared to placebo, the nebuliser-delivered approach showed a modest, but significant, improvement in lung function (3.7%).
A 3.7% improvement may not sound that impressive, but the exciting news is that the technique actually worked in a few of the study’s participants in the first place. It may be possible to enhance the technique in the future to boost lung function dramatically.
In February, it was announced that, in a slightly scary manner, "microscopic stealth drones could be used to seek and repair damaged arteries".
Researchers managed to use nanoparticles – unimaginably tiny particles – to deliver a "repair protein" to sections of arteries affected by atherosclerosis. The protein repairs damage to the walls of the artery, which reduces the risk of a blood clot.
At the moment, the technique has only been used in mice. Further studies in pigs and then primates are now planned. If successful, human trials may then be conducted.
It is a question that kept both oncologists and evolutionary biologists awake at night: why do elephants have much lower cancer rates than humans?
Because of their large size, which means they have more cells that could potentially become cancerous, it would be expected they should have above-average cancer death rates.
But this is not the case. Just 1 in 20 elephants die of cancer, compared with around 1 in 5 humans. In this study, researchers wanted to see why this is and if there could be any human applications.
Researchers collected white blood cells from African and Asian elephants. They found that elephants have at least 20 copies of a gene called TP53. TP53 is known to encourage cell "suicide" when DNA is damaged, stopping any potential cancer in its tracks. In contrast, humans are thought to have only a single copy of the TP53 gene.
Of course the big question – the elephant in the room, if you will – is how we can boost TP53 activity in humans to stimulate a similar protective effect. The simple answer is: we don't know. Yet.
It's just like buses. You wait years for a potential universal flu vaccine, then two come along at once. In August, two studies were published, both on the possibility of creating a "one-size jab" for flu.
The flu virus is shaped like a ball, with many "spikes" sticking out of its surface made of a chemical called haemagglutinin. The "stem" part of this spike does not change as much as its tip or other parts of the virus, so both of these studies aimed to develop a vaccine that targeted the stem. Targeting these areas may help keep the vaccines effective, even if new strains come along.
Both vaccines were able to protect mice against what would usually be a lethal dose of flu, and one vaccine reduced fever symptoms in monkeys.
While the results were encouraging, it is likely that additional lab and animal research on both vaccines will be undertaken to ensure the vaccine's safety and effectiveness before they reach testing on humans.
Promising research was announced in January, as a research team developed a novel spinal cord implant that has been able to restore movement in paralysed rats. The implant is made of a flexible material that is able to integrate and move with the spinal cord.
This overcomes problems found with previously tested rigid and inflexible implants, which have caused inflammation and quickly stopped working.
The implant works by delivering both electrical and chemical signals, and enabled the rats to walk again for the six weeks of testing.
It remains to be seen whether implants are safe and effective at restoring movement in people with paralysis.
And finally, the five burning questions of the year:
Does happiness have a smell? (If it does, we are guessing "new car smell".)
Should we worry about the 'flesh-eating killer bug'? (No. At least, not yet.)
Could DNA editing lead to designer babies? (Quite possibly, yes. Whether that would be ethical is another question.)
Could advances in bioengineering lead to criminals making 'home-brew heroin'? (We doubt it – at least, in the near future.)
Could brain-eating cannibals provide the key to treating CJD? (Hopefully, yes.)
Keep your eyes peeled for some extra stories coming up over the festive period. Normal service will be resumed on January 4 2016.
Edited by NHS Choices.