Thursday, October 28, 2010

Freeze ovaries to boost fertility

Young women should freeze parts of their ovaries if they want to postpone motherhood until later in life, a US fertility expert has said.

Dr Sherman Silber told the American Society for Reproductive Medicine meeting in Denver a woman could freeze her ovary at 19 to use when she was 40.

Dr Silber, who says the procedure would work better than egg freezing, did the first full ovary transplant in 2007.

But UK experts warned ovary freezing had not been sufficiently tested.

Women are most fertile when they are young, with the chances to become pregnant diminishing with age, he said.

Although egg-freezing techniques are currently available at clinics in the UK, they usually harbour only a handful of eggs at a time.

It is far from enough to guarantee that a woman would be able to conceive when she decides to re-implant them in future.

Storing a part of an ovary may yield as many as 60,000 eggs, Dr Silber, who is based at the St Luke's clinic in Saint Louis, said.

He added: "The question is, how many cycles of egg retrieval do you need to feel comfortable and secure that you have enough eggs?"

"There's no absolute answer. Women who do egg freezing can't just have one cycle and think they've got it all solved."

And those who opt for several rounds of egg retrieval have to pay for every single procedure, making it "prohibitively expensive", he added.

But he said that removing and then freezing around a section of the ovarian tissue meant "one procedure and the whole thing is done".

'Too early'

Although there are already seven centres around the world that offer the storage of frozen ovarian tissue, there are none in the UK.

Tony Rutherford, chairman of the British Fertility Society, said the research was still very recent and much more needed to be done to ensure the procedure's effectiveness, especially in how successful the re-grafting of the ovarian tissue when a woman was ready to try and conceive would be.

"We don't know how many people have grafts and therefore we don't know how many have been successful and how many have failed," he said.

"Start Quote

People need to know that it is not a guarantee"

End Quote Susan Seenan Infertility Network UK

"We need to see clear evidence of [the method's] effectiveness and that's what we don't have at the moment."

Dr Silber claimed his hospital in Saint Louis has so far managed to carry out three successful ovarian tissue transplants using frozen tissue, which resulted in three births.

There have been 23 babies born from ovary or ovarian tissue transplants worldwide.

Fertility 'epidemic'

Dr Silber added: "We are in the middle of a fertility epidemic across the developed world and the reason our society is changing," he said.

"People are not trying to have children or are not even thinking about getting married until they are 35."

But Susan Seenan of Infertility Network UK told BBC News there was no guarantee that any of the currently used methods, including IVF, would ensure a woman could conceive.

"People should be very careful not to rely on this as a guarantee of success in the future, because you can't actually ensure your fertility.

"There could be other fertility issues, such as blocked tubes or an infertile partner.

"People need to know that it is not a guarantee."



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Councils 'slow' on care budgets

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Arvinda Patel says the use of personalised budgets has enhanced her mother's care

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Many councils are struggling with moves to give individual people their own budgets to spend on social care, a watchdog claims.

The Audit Commission warns some need to make significant efforts to meet targets agreed for England last year.

In particular, people with mental health problems could miss out, it claims.

The Department of Health welcomed the report, urging councils to speed up reform.

"Personal budgets" are designed to give people who use social care, and their carers, more choice and control over how their services are provided.

"Start Quote

Some have achieved dramatic things but the progress in others raises questions"

End Quote Richard Humphrey King's Fund

The money to pay for them can be provided directly to the user in cash, or held and used on their behalf by a council or private care firm.

The policy, launched in 2007, was backed by the coalition government in May this year.

Challenges

However, the Audit Commission, an independent body which looks at the effectiveness of public bodies in England, says that while some local authorities are on course to meet a target by offering 30% of eligible people their own budget by April 2011, most are not.

Only six of the 152 councils are currently meeting it, the watchdog adds.

What is more, a survey earlier this year showed only 6% of total spending on adult social care had so far been allocated to personal budgets.

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Andy McKeon from the Audit Commission says the system worked well for his own father

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The latest report, compiled using national statistics and in-depth analysis of 12 councils, suggests that local authorities face various challenges when introducing personal budgets to the thousands of local people who need them.

Not only do they have to decide exactly how much money to give each "budget-holder", but they have to change their financial systems to cope with the new system, and provide information to people on how to use it, while making sure that there is a local "market" in social care where the budgets can be spent.

Andy McKeon, managing director of health at the Audit Commission, said: "Introducing this radical change in the funding of social care is a challenging, and ongoing process.

"The rationale behind personal budgets is not saving money, but empowering service users. Personal budgets mean personal choice."

Richard Humphrey, from the King's Fund think-tank, said that the response of some councils had been "disappointing".

"Some have achieved dramatic things but the progress in others raises questions - in one council, 60% of eligible people have a budget, while in another, it's just 13%.

"Councils have all signed up to this - now they need strong leadership to get on with the job."

One of the problems highlighted by the watchdog is social care for people with mental health issues.

Providing personal budgets would mean disentangling money not just from local authority funds, but from NHS funds as well.

'Financial risk'

Many authorities questioned did not provide budgets for these people - with some saying there was a "financial risk" in giving individuals with mental health problems control of their own funding.

Simon Lawton Smith, from the Mental Health Foundation, said that it was not a "good omen" for the future.

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LGA's Richard Kemp: "We think this report is out of date"

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However, a spokesman for the Local Government Association, which represents councils, said that the report was "somewhat outdated", with significant progress made since its figures were gathered.

Local authorities remained committed to personal budgets, and a fresh agreement between all the bodies involved in social care would be announced at a conference next week.

A Department of Health spokesman said that the report echoed its own messages to councils.

He said: "This should help those councils that still need to get to grips with their financial systems to pick up the pace of reform."



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Tuesday, October 26, 2010

�600m cancer drug fund announced

Patients in England will benefit from a �600m fund to improve access to cancer drugs over the next three years, the government has confirmed.

The move is to address the UK's poor record of cancer treatment provision compared with the rest of Europe.

Health Secretary Andrew Lansley said cancer patients were already getting extra treatments thanks to an interim fund of �50m which began in October.

From next April, the first of three annual �200m sums will be available.

Mr Lansley said this would enable NHS doctors to buy drugs for their patients that can extend life or improve its quality.

"This �200m a year funding over three years for cancer drugs is a crucial step forward in addressing the disparity in patients' access to cancer drugs in England compared to other countries.

"My aim is to truly empower patients."

Greater availability

A recent analysis ranked the UK 12th out of 14 developed countries - which included much of Western Europe, North America, Australia and New Zealand - on access to cancer drugs that have come onto the market within the past five years.

Experts said part of the reason was because some of the newer cancer drugs had not been approved by England's drugs regulatory body, the National Institute for Health and Clinical Excellence (NICE).

The extra money should make it easier for doctors to prescribe treatments even if they have not yet been approved by NICE.

Mr Lansley said NICE would continue to appraise most significant new drugs, and would have "an important part to play" in longer-term plans to introduce "value-based pricing" for new medicines.

Hilary Tovey, of Cancer Research UK, said: "This cancer drugs fund could make a real difference for some cancer patients, allowing them to get the treatments they need.

"It's crucial that cancer patients have easy access to the best drugs and that the way this happens is transparent and easy for doctors and patients to understand.

"How this fund operates will be crucial to its success. All patients - wherever they live - must be able to access this fund in a clear and consistent way.

"Its use will need to be carefully monitored, so we can be sure it's being used in the way that benefits patients most."



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Tall men risk testicular cancer

Taller men may have a higher risk of getting testicular cancer, say experts in the United States.

After looking at data on more than 10,000 men, researchers found that for every extra two inches or 5cm in height above average, the risk went up by 13%.

But experts stressed the lifetime risk of developing this cancer is low - one in 210 for men in the UK.

So even for men exceeding the average height of British men (5ft 9ins), the risk would remain relatively small.

And the National Cancer Institute researchers still do not understand how increased height raises a man's risk of testicular cancer.

Other factors, like family history, carry more of a risk, they told the British Journal of Cancer.

Fewer than 2,000 new cases of testicular cancer are diagnosed each year in the UK, accounting for just 1% of male cancers.

Height link

The data the US team analysed came from 13 different studies investigating testicular cancer.

"Start Quote

Tall men should not be alarmed by this research since fewer than four in 100 testicular lumps are actually cancerous"

End Quote Sara Hiom Cancer Research UK

All of these studies, spanning the last decade, included both figures on the cancer's incidence and height records of the men involved.

Dr Michael Blaise Cook and his team looked at the data to see if cancer risk might tally with height and weight measurements.

They found no link between body weight and the cancer but a trend emerged with height, with taller men at increased risk of testicular cancer.

Sara Hiom, director of health information at Cancer Research UK, said: "Tall men should not be alarmed by this research since fewer than four in 100 testicular lumps are actually cancerous.

"But it is still important for men to be aware of any changes to the size and weight of their testicles and not delay seeing their GP if they are concerned. This is particularly true for young men as the disease is more common with under-35 year olds.

"The outlook for testicular cancer is also one of the best for all cancers - even after the disease has spread, patients can be cured."



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Monday, October 25, 2010

&#39;Contraceptive gel&#39; shows promise

A birth control gel that is applied to the skin could offer woman an alternative to the Pill, say experts presenting latest trial data.

Used once daily, it delivers hormones to prevent a pregnancy in the same way as oral contraceptives do.

Early studies show the gel is effective and well tolerated, with none of the typical side effects associated with the Pill, like weight gain and acne.

The Nestorone gel is being developed with drug firm Antares Pharma.

Researchers told the American Society for Reproductive Medicine how they hope to bring the product to market if clinical trial results continue to be positive.

The gel can be applied to the abdomen, thighs, arms or shoulders and is quickly absorbed, with no residue.

Experts say it is also suitable for women who are breastfeeding, unlike the combined Pill which can interfere with milk supply.

Dr Ruth Merkatz from the not-for-profit Population Council research centre in New York led the latest study, which involved 18 women in their 20s to 30s.

"Start Quote

There are approximately two million women using a contraceptive method that they are unhappy with, so they will benefit from improved choices and options"

End Quote Natika Halil The Family Planning Association

The research found the optimum dose of the gel was 3mg a day.

Over the course of seven months, none of the women using the treatment fell pregnant. Hormone studies showed the gel suppressed the production of eggs by the ovary.

Dr Merkatz said: "From this small study we found it was effective.

"It's in early stage development but if we move on, we will obviously test it in many, many more women."

The researchers say it could offer an alternative to the Pill, which is used by over 3m women in the UK alone.

Natika Halil, director of information at the Family Planning Association, said: "Any contraceptive system that increases the choice of methods available to women and helps to prevent unwanted pregnancies is welcome.

"Our research shows that there are approximately two million women using a contraceptive method that they are unhappy with, so they will benefit from improved choices and options.

"This product won't suit everyone and will only be for women comfortable (with) putting it on their skin and having their contraceptive cover that way."

Simon Blake, chief executive of sexual health charity Brook, said: "Obviously this is still in the very early stages of development but anything that can help young women has got to be a good thing.

"Clearly what young women need is more choice."



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New polio vaccine more effective

A new vaccine against the polio virus has helped reduce the number of cases by more than 90%.

Research published online in the journal The Lancet, shows that the new vaccine is significantly better at protecting children against polio than the current popular vaccine.

It has already been used in Afghanistan, India and Nigeria.

The scientists behind the work believe this new vaccine could help to finally eradicate the disease.

Disease elimination

Mass vaccination campaigns have led to the number of polio endemic countries falling from 125 in 1988 to just four in 2005.

This meant an actual drop in cases from 350,000 to just 1,606 in 2009.

Polio is caused by one of 3 versions of the polivirus: type1, type 2 or type 3.

Until recently, vaccines targetting either all three forms of the virus or just one of them were used to immunisie children.

The last case of type 2 polio was recorded in India in 1999, so it's the other two types that need to be targeted to finally eliminate the disease.

"Start Quote

This vaccine could get us over the top and get us to the finish line for eradication."

End Quote Dr. Roland Sutter WHO

The authors of the study carried out a trial in India comparing the commonly used old vaccines to the new one, which is taken orally.

In total, 830 newborn babies received either the new vaccine or one of the old vaccines in two doses - one at birth and one 30 days later.

Blood samples were taken before vaccination and after the first and second doses to measure seroconversion - the rise in antibodies produced by the immune system against polio.

It appears that the new vaccine is about 30% more effective in protecting against polio than the most commonly used vaccine to date.

Finish Line

The new vaccine has already been used in immunisation campaigns in Afghanistan, India and Nigeria.

In India the number of cases this time last year was 464. Over the same period this year there have only been only 39 cases.

Nigeria has seen an even greater difference, with cases falling by 95%.

The new vaccine and improved immunisation programmes appear to be responsible for this significant decrease, according to the World Health Organization (WHO).

Dr Roland Sutter, from the WHO and the lead author of the study, told BBC News: "This (new) vaccine could get us over the top and get us to the finish line for eradication.

"The dramatic drop in the number of polio cases in India and Nigeria is attributable to the new vaccine and better coverage during immunization campaigns."

Commenting on the research, Nigel Crawford and Jim Buttery from the Murdoch Children's Research Institute (SAEFVIC) in Melbourne, Australia, said that the new vaccine had shown great promise.

However they cautioned that the global financial crisis had resulted in a massive funding gap for immunisation programmes worldwide, including polio.



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