Public awareness of the hazards of asbestos can be dated to the period immediately following the death of Nellie Kershaw aged 33 in 1924. She had worked during the previous seven years in a textile factory spinning asbestos fibre into yarn. She died of severe fibrosis of the lungs. The pathologist, William Cooke, who found retained asbestos fibres in the lungs, called the cause of death asbestosis. Nellie Kershaw was not the first case to be reported of lung fibrosis caused by asbestos. Montague Murray in 1899 had reported the case of a 33-year-old man who had worked for 14 years in an asbestos textile factory. He had died of fibrosis of the lungs which Montague Murray, also finding asbestos in the lungs, had attributed to inhaled asbestos fibres. The patient had told Murray he was the only survivor from ten others who had worked in his workshop.
However, unlike the Montague Murray case, which had aroused little interest, the death of Nellie Kershaw and its cause was widely reported. It led to the government commissioning the Chief Inspector of Factories, Edward Merewether, with an engineer, Charles Price, to report on workers’ health in the asbestos industry. They found, among those still at work who had been employed for more than five years, one third had asbestosis and of those still working in the factory after 20 years, four-fifths had the disease.
The government introduced regulations in 1931 to control exposure to asbestos, together with arrangements for regular medical surveillance of the workforce and eligibility for compensation for factory workers with asbestosis. A benefit commented on by the workers in one factory was a clock on the wall becoming visible to them for the first time. (more…)
Medical imaging is key in today’s delivery of modern healthcare, with an immense 41 million imaging tests taking place in England in every year. Thousands upon thousands of patients safely undergo imaging procedures such as X-ray, ultrasound, and MRI every day, and the product of these tests – the images – play an essential role in informing the decisions of medical professionals and patients in nearly every area of disease.
At its core, medical imaging is the application of physics, and sometimes biochemistry, to visually represent the biology and anatomy of living humans. We have progressed from the first, blurry, x-ray in 1895, to being able to measure minute changes in oxygenation within the brain; whilst major technological advancements continue to be made every year. In the field of medical imaging, these techniques are applied to expand our understanding of the human body and disease in research settings, but much of this technology does not actually make it into every day clinical practice. For me, this has been the drive to move from a career in sonography into clinical research: to implement novel technology and investigate how it can be used to improve patient care.
One of these advancements is the use of image analysis technology to obtain more information from medical images. There has always been an interest in the use of computers to analyse medical images as computers are not biased by optical illusions or experience like human readers are. In image analysis, an image is no longer considered as visual, but rather as digital information. Each pixel contains a value representing biophysical properties, and you can write a program that finds a specific pattern or feature across the image that can represent disease. However, this process is time-consuming, and a single feature probably doesn’t represent a disease very accurately. (more…)
World AIDS Day takes place annually on 1 December as an opportunity for people worldwide to unite in the fight against HIV and to show support for people living with HIV/AIDS.
To mark World AIDS Day 2017, we have published a series of blog posts to highlight the important and varied research that takes places at Imperial. Three experts from Faculty of Medicine share their interest in HIV/AIDS which spans from the elusive vaccine to the economics of the epidemic.
Oncologist turned HIV expert
As a medical oncologist at Chelsea and Westminster Hospital, I specialise in the treatment of HIV-related cancers at the National Centre for HIV Malignancy – Europe’s largest research and treatment institute for these cancers. Over the last 25 years, I have seen an astonishing improvement in the outcomes of people diagnosed with both HIV and cancer, so that patients under my care with most HIV associated cancers now have the same overall survival as HIV negative patients.
The population of people living with HIV is ageing
One less welcome finding in recent years is the rising number of non-AIDS defining cancers – cancers not previously associated with severe immunosuppression and AIDS – amongst people living with HIV. Overall, the risk of cancer rises with age, although the age-related risk of individual types of cancers varies. In the UK half of all cancers are diagnosed in people over the age of 70 years old. The combination of increasing age of people living with HIV and the rising rates of cancer with age, is reflected in the changing epidemiology of non-AIDS defining cancers amongst people living with HIV. This was first described in the US by Shiels in 2011 who reported a three-fold rise in the rates of non-AIDS defining cancers between 1991 and 2005, and by 2005, 60% of these cancers occurred in people over 50 years old. We have since described the same phenomenon at the National Centre for HIV Malignancy, Chelsea and Westminster Hospital and in a pan-European cohort. (more…)
It’s that time of the year again, when men grow moustaches around the globe. It all started in 2003, when two guys in Australia had the idea to make moustache-growing fashionable again. For a greater cause, they made this campaign about men’s health and established the Movember Foundation. As you may know, the campaign became an international phenomenon, attracting over 300,000 participants in more than 20 countries in 2016.
The Movember Foundation is now a global charity with one mission: “Stop men dying too young”. To achieve this, they are raising awareness and funds for three issues affecting men’s health; prostate cancer, testicular cancer and mental health. Here in the UK, the Movember Foundation has been working together with Prostate Cancer UK – the only charity that exists solely for prostate cancer – investing over £21 million in prostate cancer research between 2012 and 2015.
The prostate is a male-specific organ that sits just beneath the bladder and surrounds the urethra – this location is the reason so many symptoms of prostate disease affect the ability to urinate. Prostate cancer occurs when cells in the prostate grow and divide out of control. In the UK, prostate cancer is the most common cancer amongst men and expected to affect 1 in 8 men during their lifetime. The word ‘cancer’ sounds frightening, but it needn’t be for all cases of prostate cancer. When diagnosed at the earliest stage, virtually all men survive beyond 5 years. However, when diagnosed at the latest stage (advanced prostate cancer) only 30% of men survive beyond 5 years, indicating early detection is key. (more…)
Most of us are aware that chronic, heavy alcohol consumption and binge drinking leads to a plethora of health issues including liver damage and addiction. However, many of us are still unaware of the dangers associated with even moderate alcohol consumption or the cumulative effects that alcohol can have on our health. So just what are those regular trips to the pub, or the frequent cocktails after work really costing us?
Research into effects of alcohol provide a range of results. Some research (funded by the alcohol industry) has even been claimed to demonstrate that alcohol consumption is actually beneficial to our physiological health. Conversely the International Agency for Research into Cancer has demonstrated that the more alcohol you drink directly increases the risk of seven common cancers including: mouth, throat, oesophageal, larynx, breast, liver and bowel.
Similarly, new research published in the British Medical Journal has revealed a potential link between moderate drinking and shrinkage of the hippocampus, a brain region associated with memory. These results suggest a link between moderate alcohol consumption and a potentially permanent alteration in brain structure. (more…)
For the last 10 years I have been a clinical scientist in genetics working across various London NHS Trusts. Whilst I loved diagnostics, last year I left my job to complete my PhD. I worked in a part of life sciences called cytogenetics. This meant when a patient was diagnosed with blood cancer, I would analyse their chromosomes – the structures into which DNA is organised – from their blood or bone marrow to look for specific abnormalities. For some patients, this can lead to a definitive diagnosis. For others a refined prognosis, and in some, it’s simply a way of monitoring how well the patient’s leukaemia is responding to their treatment.
Blood cancer can be very straightforward to diagnose and it was perfectly possible to provide genetic confirmation of a blood cancer diagnosis in a matter of hours. For example, in patients with chronic myeloid leukaemia (CML), I would find a particular abnormality called a Philadelphia translocation between chromosomes 9 and 22. Finding this translocation means a patient will benefit from a targeted therapy – called a tyrosine kinase inhibitor (TKI) – which reverses the effect of the translocation with relatively few side effects. TKIs are a tablet taken once or twice a day at home. Compared to chemotherapy, TKIs have revolutionised the treatment and outcomes of CML, which has been life-changing for CML patients. It was always satisfying to call the referring clinician and let them know their patient had a Philadelphia translocation because I knew that would set the wheels in motion for a TKI to be prescribed. Ultimately I knew I had made a difference to a patient on those days. (more…)