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Friday, December 9, 2011

Weight loss battleground moves as genes found linked to fat storage capacity

The weight loss debate has moved as researchers at the University of Edinburgh have identified a number of genes in fat tissue that may lead people to retain weight unnecessarily in the body. They hope the discovery could eventually lead to the development of medicines targeting obesity.

Scientists compared fat tissue from mice that had been selectively bred for many generations to be increasingly fat or thin, and as a result had acquired weight-related genes.

The researchers then pinpointed genes that prevented the breakdown of fat, which were more prevalent in the fat tissue of the overweight mice compared to the fat tissue of the lean mice.

Mice were then bred from one overweight parent and one lean parent.

The offspring that turned out to be overweight were found to have the same active genes as the fatter parent mouse, suggesting that hereditary factors play a role in fat storage and can increase the likelihood of putting on weight.

Dr Nik Morton, a Wellcome Trust research career development fellow at the University of Edinburgh’s Centre for Cardiovascular Science, said: “While genes controlling appetite are known to be important in determining our fatness, our study shows that genes switched on in the fat tissue itself can play a role in determining why some people tend to hang onto their fat more easily than others.”

“While this supports the idea that genetic factors are linked to obesity, exercise and diet are still important for healthy lifestyles and can prevent most people from becoming obese.”

“If we can identify the genes and proteins that are controlling how fat we get, we may be able to target them with medicines to try and target the obese or the consequences of obesity.”

The research also found that the thin mice offspring had an added protection against weight-gain.

When both sets of mice were given fatty foods, the thin offspring appeared able to break down fatty tissue more easily than the heavier mice, suggesting they had inherited elusive “lean genes”.

The research was funded by the Wellcome Trust and published in the journal PLoS One.

Nurses discuss ill patients on Facebook

NHS staff are putting patient confidentiality at risk by sharing information about them on Facebook new research has revealed.Private records belonging to ill and vulnerable patients were breached more than 800 times over the last five years by nurses, doctors and administrative staff at 152 NHS trusts and hospitals.

Nearly half said there had been at least one breach in the past year, a report by the campaign group Big Brother Watch found.

In one incident at the Nottingham University Hospital NHS Trust, a member of medical staff was dismissed after taking a photograph of a patient in bed and showing it to friends on the social networking site.

The report comes after the Information Commissioner said tougher powers were needed so that those who break data protection laws to obtain personal details could be jailed.

The figures, released under the Freedom of Information Act, showed there were at least 806 incidents in which NHS employees breached data protection policies between July 2008 and July 2011.

In 23 cases, medical staff posted confidential medical information on Facebook, sharing details about a patient’s name, medical condition or discussing their treatment.

There were more than 90 incidents where employees admitted to inappropriately accessing the medical files of colleagues, and more than 30 incidents where they looked up family members, the figures showed.

Their actions led to a total of 102 doctors, nurses and hospital staff being sacked.

The figures also showed unsecured confidential medical information was lost on 57 occasions across 24 NHS trusts.

Christopher Graham, the Information Commissioner, warned in July that a culture change was needed within the health service to ensure patients’ personal information was kept secure.

Nick Pickles, director of Big Brother Watch, said “urgent action” was needed to keep medical records safe.

“This research highlights how the NHS is simply not doing enough to ensure confidential patient information is protected,” he added.

“The information held in medical records is of huge personal significance and for details to be disclosed, maliciously accessed or lost represents serious infringements on patient privacy.”

He added: “It is essential the NHS is transparent about these incidents and failing or refusing to disclose that a data breach has taken place is unacceptable.”

Obesity and chronic disease cost UK PLC £20 billion a year

Obesity and chronic health conditions such as high blood pressure and diabetes cost Britain £20 billion a year in terms of lost productivity, analysis by the polling firm Gallup has found.Overweight and obese workers with no chronic problems take twice as many days off as comparable workers of a healthy weight, found the survey of almost 9,000 people.

Those who were overweight or obese and had three or more chronic health problems took 12 times as many sick days as healthy weight individuals with no health problems, or 18 compared to 1.5.

The survey was conducted by Gallup and Healthways, a firm that runs fitness centres.

It also found obesity alone counts for six lost work days per worker each year – or over £1,200 in lost productivity.

Ben Leedle, president and chief executive of Healthways, said it showed that the level of chronic disease in the UK workforce was at “alarming levels”.

He said: “Employers who recognize the importance of improving well-being at the workplace are most likely to gain a competitive advantage.”

Overseas patients owe health service £60 million

Overseas patients owe the NHS almost £60 million in unpaid medical bills, with foreign governments among those with the biggest debts.The figures, which cover the past six years, show an increase in the number of visitors leaving the country without paying for treatment.

Embassies and foreign governments have run up debts of nearly £6 million at two London hospitals after failing to pay for non-emergency treatment, according to figures released under the Freedom of Information Act.

More than £4 million is owed to Great Ormond Street children’s hospital by Middle Eastern governments that arrange for children to have treatments not available in their own countries.

While much of the debt is still being chased, more than half has been abandoned or written off.

Free NHS hospital treatment is available to British residents. Overseas patients are charged for the full cost of any treatment they receive unless a specific exemption applies.

Urgent treatment is always available to overseas visitors, regardless of their residence status or ability to pay, but non-urgent treatment should not go ahead without the NHS first receiving payment.

In 2009, West Middlesex University Hospital, in west London, became the first to tell foreign patients they must pay in advance.

The figures reveal that hospitals threatened with closures over mounting debts have written off some of the highest amounts. Imperial College trust, which is £100 million in debt and in the process of making major cuts, is owed £2.5 million and has written off a further £2 million.

The trust for Chase Farm hospital, in north London, which received a bail-out from the Challenged Trust Board and is being forced to close its A&E department, has a foreign debt of £2.5 million.

The Government recently introduced a policy to deny new visas to tourists with outstanding NHS payments.

The burden on the taxpayer is expected to increase next year with one million extra visitors and foreign dignitaries attending the Olympics in London.

Separate figures show that European governments owe £38.5 million to Britain under the system that allows visitors free emergency treatment on the NHS.

Statistics released in a Parliamentary written question show that almost half of the total owed in the European Health Insurance Card scheme, £17.2 million, is due from Ireland.

Katherine Murphy, chief executive of the Patients Association, said: “At a time when the NHS needs to make £20 billion of savings by 2014, why are managers at hospitals not desperately chasing these unpaid bills? Why are we writing off this money and throwing it down the drain when it could be used to fund front line services and help patients?”

Simon Burns, a health minister, said: “Hospitals must take every reasonable measure to recover any debts from overseas patients. The NHS has a duty to anyone whose life or long-term health is at immediate risk, but we cannot afford to become an international health service, providing free treatment for all.”

Overweight mothers give birth to fat babies new research finds

Childhood obesity appears to begin in a mother’s womb, a new study has concluded using state of the art technology to monitor fat levels in unborn babies.Researchers found some babies have similar build up of fat around their abdomen that adults aged in their 50s have.

The study of babies at Chelsea and Westminster Hospital, west London, used magnetic resonance imaging (MRI) scans to investigate links between childhood obesity and their mothers.

It reportedly found evidence that being overweight or obese in pregnancy could result in potentially harmful changes to a baby’s fat levels while still in the womb.

The study, led by Prof Neena Modi, one of Britain’s best experts on high-risk health problems in newborns found nearly a third of children had more fat than expected.

Of the 105 babies – 54 boys and 51 girls – a total of 31 babies had more adpose, or fat, tissue around their abdomen than normal.

Experts said the study was the first direct link that proved the weight of a mother-to-be was passed on to her child and showed that overweight mothers gave birth to fat babies.

“I was very surprised to be able to detect such a clear continuum of effect of maternal BMI (body mass index) on the baby,” said Prof Modi, head of neonatal medicine at Imperial College London.

“This is a very important finding indeed, opening the door to a new understanding of how a mother’s metabolism affects her baby.”

Newborn babies usually have about 700g of adipose tissue, but for each unit increase in maternal BMI, this increased by approximately 7g with a huge build-up in fat in the babies’ livers.

Meanwhile in adults, adipose tissue is found mainly under the skin, but also in deposits between the muscles, around the intestines and around the heart.

Prof Modi, who is also a consultant neonatologist at Chelsea and Westminster Hospital, told the Daily Mail that all women should be aware of the effects of being obese and what this means for their child.

“This shows how sensitive the baby is to the environment experienced within the womb and how lifelong effects may be initiated before birth,” she said.

Body mass index is calculated by dividing a person’s weight in kilograms by the square of their height in metres.

The World Health Organisation classes a BMI between 18.5 and 25 as normal weight, between 25 and 30 as overweight and over 30 as obese.

In adults, high amounts of fat around the stomach and in the liver impair their control of blood sugar, leading to diabetes. Problems associated with obesity are set to cost the NHS up to £6.3 billion a year by 2015.

Paramedic patients resuscitation advice- DNR if patients want to die

Paramedics are to be told if a patient does not wish to be resuscitated or wants to die at home, under plans backed by ministers.Adults in Britain can legally refuse medical treatment, even if it leads to their death but doctors cannot undertake treatment to a patient if it clashes with any clinical judgment.

Patients should, however, be given an opportunity for a second opinion wherever possible.

While the General Medical Council (GMC), the doctor’s watchdog, said last year there was no absolute obligation to prolong life, the medical profession does have a final say about whether resuscitation is in the patient’s best interest.

This has led to accusations from some critics who believe doctors are “playing God” and ignoring vulnerable patients’ right to life.

It has also prompted fears that as hospitals face deeper budget cuts, not resuscitating patients will become a cost-cutting option. It is thought that four in five people who die in hospital are the subject of “do not resuscitate”(DNR) orders.

Cardiopulmonary resuscitation (CPR) attempts to restore breathing or blood flow to those whose heart has stopped beating or who have stopped breathing.

It can include using electric shocks to try to correct the rhythm of the heart, repeatedly pushing down firmly on the patient’s chest and inflating the lungs with a mask or tube inserted into the windpipe.

While television medical dramas suggest it is often successful less than a fifth of those who have had such treatment actually go home, according to the British Medical Association (BMA). Inevitably, the young and fit are more likely to survive than the frail and elderly.

In 2007 the BMA, together with the Resuscitation Council (UK) and the Royal College of Nursing, issued joint guidelines on the issue in a 25 page document titled “decision relating to cardiopulmonary resuscitation”.

Legal experts say the “do not resuscitate” advice is essential where a “patient or their family disagree with doctors about whether a particular treatment is futile, a burden rather than a benefit, or inappropriate”.

Roger Goss, the co-director of Patient Concern, has raised concerns previously that “do not attempt resuscitation” orders are being misused.

“We are concerned that patients are having “do not resuscitate” written on their notes without they or their relatives knowing,’ he said earlier this month.

‘Bearing in mind NHS budget cuts over the next few years, it is not far-fetched to foresee that “do not resuscitate” orders will proliferate to the point where everyone over a certain age — perhaps 65 or 70 — gets one stuck on them.”

In England, Andrew Lansley, the Health Secretary, has stopped short of a national policy.

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