20180408

What is shingles? A look at the virus after Lin-Manuel Miranda's diagnosis
Hamilton creator Lin-Manuel Miranda says he's been diagnosed with shingles. Miranda tweeted earlier this week that he had one of the worst headaches of his life. But it turns out, that was a symptom of the viral infection.
shingle【名】砂利浜《shingles》《医》帯状疱疹
worst headache of one's life《the ～》これまでの人生の中で最悪の頭痛
水痘のウイルスが神経節中に潜伏している状態（潜伏感染）が続く（この状態自体に害はない）。ストレスや心労、老齢、抗がん剤治療・日光等の刺激などにより免疫力が低下すると、ウイルスが神経細胞を取り囲んでいるサテライト細胞の中で再度増殖する（再活性化する）ことがある。この増殖によって生じるのが帯状疱疹である。ウイルス再活性化のメカニズムは不明。
神経節（しんけいせつ、ganglion）は、中枢神経以外の末梢部において神経細胞が集合し、周囲から明確に判別される構造をいう。
One in three Americans will get shingles in their lifetime, according to the Centers for Disease Control and Prevention.
Shingles is caused by the varicella zoster virus (VZV), the same virus that leads to chickenpox. Anyone who has recovered from chickenpox may develop shingles at some point later in life, and the risk increases for adults over the age of 50.
varicella zoster virus水痘帯状ヘルペスウイルス
chickenpox【名】《病理》水痘《獣医》鶏痘
CBS News chief medical correspondent Dr. Jon LaPook explains that after the itchy, blister-like rash from chickenpox goes away, the virus doesn't totally leave your body.

"It stays inside in these nerve collections called ganglia. And if you get weakened, if you get immunocompromised, if you're under stress or some other kind of problem, they can come out," he said.
ganglion神経節
immunocompromised【形】免疫システムが損なわれた、免疫力がない、免疫障害を持つ、免疫欠陥を持つ、免疫不全（症）
Chickenpox and shingles present somewhat differently, though. The painful rash associated with shingles appears in what's called a dermatome.
dermatome【名】皮節、採皮刀、真皮節
"It's a wedge-like distribution," LaPook explained. "It's only on one side of the body. It could be on your chest, on your side, on your face."
Since his diagnosis, Miranda has tweeted that his illness was caught early and he is quarantined from his 8-week-old son, Francisco, to protect the child.
Shingles itself cannot be spread to another person, but the varicella zoster virus is highly contagious and can cause chickenpox in someone who has not been vaccinated. The first dose of the chickenpox vaccine is administered to babies at 12 to 15 months. The second dose is given at 4 to 6 years of age.
LaPook notes that in order to get shingles, you had to have recovered from chickenpox or received the chickenpox vaccine.
"The vaccine is a live attenuated vaccine, which means a weakened form of the virus," he said.
attenuated【形】弱毒化した
However, getting the chickenpox vaccine does not mean you're at an increased risk of shingles.
"The vaccine actually decreases your risk of getting full-blown chickenpox and decreases your risk of getting shingles, but you can still get shingles after having gotten the vaccine."
The U.S. Food and Drug Administration approved a new shingles vaccine called Shingrix in 2017. The CDC recommends that healthy adults 50 and older get two doses of Shingrix, two to six months apart.
LaPook said the vaccine is not without side effects and some of his patients have complained of pain at the site of injection and flu-like symptoms.

For many people who get shingles, the rash will clear up in 2 to 4 weeks. But in some cases it can lead to a lingering, painful condition called postherpetic neuralgia (PHN).
postherpetic neuralgia
ヘルペス後神経痛、帯状疱疹後神経痛"In plain, simple words, that means you get the shingles, the rash may go away, but then you have this pain that can persist for weeks, months, even years," LaPook said. "So the bottom line is the reason why the CDC is recommending getting this new vaccine is to try to prevent not just shingles but postherpetic neuralgia."
bottom line〈話〉肝心［主要］なこと［点］ 
 

20180407

The doctor who really feels his patients' pain
For Dr Joel Salinas, music creates colours, numbers have personalities and another person's pain feels almost like his own. He thought that was how everyone experienced the world - until he went to medical school.
Joel Salinas rushes in to the hospital bathroom and throws up until he's dry heaving. Washing his face, the third-year medical student stares at his pale reflection in the mirror and wills himself to live.
throw up【句動】吐く、嘔吐する
dry heaves空吐き 吐き気はあるが嘔吐物は出てこない
He doesn't know it yet, but Salinas has a condition called mirror-touch synaesthesia. Any time he sees someone experience pain, or even just the sense of touch, his brain recreates the sensations in his own body. And on this day in 2008 he has just watched someone die.
mirror-touch synesthesiaミラータッチ共感覚
"Someone had a cardiac arrest and it completely caught me off guard," he says.
catch someone off guard（人）の不意［隙］をつく、（人）の油断に付け込む、（人）の油断しているところを襲う
"I saw them getting chest compressions and I could feel my back on the linoleum floor and the compressions on my own chest. I felt the breathing tube scraping down the back of my throat."
When the patient was declared dead 30 minutes later Salinas experienced an "eerie silence".
"I had this complete absence of physical sensations. It was so haunting. It was like being in a room with an air conditioner and suddenly it was switched off," he says.
haunting【名】幽霊の出現、心霊［怪奇］現象、たたり
He escaped to the bathroom where he reassured himself he wasn't dead - and vowed he wouldn't let himself react so strongly again.
Synaesthesia is a condition in which one or more of your senses is merged with another rather than experienced separately. Some people perceive taste when they hear music while others experience colours when they look at letters and numbers.
merged with《be ～》～と合併する
Salinas has early memories of the condition such as the bell ringing in blue and yellow at his primary school in Florida.
"When colouring in at school I was very specific that my B had to be just the right shade of orange and that my number one had to be yellow," he says.
"Sums also didn't make intuitive sense to me. My two was a red maternal person and my four was a blue friendly person. So how could a two plus a two equal a four?"
However, his colour associations also helped him remember information making him "a whizz at vocabulary and spelling".
Salinas struggled to fit in with his peers and remembers asking his mother why nobody liked him. One problem was that he was too forthcoming with hugs.
forthcoming with《be ～》進んで［積極的に］
"Hugging was a wholly immersive experience," he wrote in his 2017 book, Mirror Touch.
It made him feel warm and secure and a "cool silvery blue, the same feeling the number four inspired in me".
But when he hugged other children, they often thought it was weird.
After frequent rejections Salinas withdrew further into his own world. He watched TV for hours as he enjoyed the way his whole body mirrored the sensations of every touch and movement on screen.
"When the cartoon Road Runner stuck out its tongue, I'd feel as if mine was sticking out. When the coyote got hit by a truck, I'd feel it," he says.
Salinas realised as a teenager that making others feel better made him feel better, due to this shared sensory experience. He found he was drawn "to healing people" and decided to pursue a career in medicine.
drawn to《be ～》～に引かれる、～に魅力を感じる、～に惹きつけられる
He hadn't talked about his experiences up to this point as he had just assumed everybody experienced the world the same way. However, on a college trip to India in 2005 Salinas discovered this wasn't the case. When a fellow medical student described a group of people who perceived colours with letters, Salinas remarked that this was the case for most people.
remark【他動】～に気付く、～だと分かる
"He looked at me and said: 'That's absolutely not the case for everyone,'" Salinas says.
But understanding this did nothing to prepare him for the difficult experiences that came in the next stage of his studies.
"The mirror-touch pain was most vivid at medical school when I began to see the extremes of physical trauma," Salinas says.
When he watched a teenage boy on an operating table he felt the incision as if it was slicing into his own abdomen, followed by the "hot and writhing experience" of seeing the boy's internal organs.
writhe【自動】身をよじる、身もだえする、苦悶する
It all came to a head on the day a patient died, and he found himself vomiting in the hospital bathroom. He realised he had to find coping techniques if he was to make it as a doctor.
Salinas found mirror-touch sensations were more vivid when he was surprised or if the person he observed was physically similar to himself. So he started to prepare himself for such situations.
"I focused looking at a patient's sleeve or collar, or on grounding myself in my own body," he says.
But he also found his "hyper-empathy" helped him to treat his patients. He would notice almost immediately if they were thirsty or in pain, picking up on the slightest facial and body movements.
"I really have a stake in my patients' well-being, because in that moment it's also my well-being," he says.
have a stake in～と利害関係がある、～に関係がある、～に関心を寄せる、～に出資している"
Being in hospital can be very lonely for the patient and being able to in some way inhabit the same space means a lot."
Synaesthesia research was still in its early days in 2007 when he visited the leading expert, neurologist Dr V S Ramachandran, to take part in some tests.
He was told that his experience of feeling touch when he saw someone else being touched was a newly discovered type of synaesthesia called mirror touch. It could affect as many as 1.6% of the population, according to a study led by Michael Banissy.
Salinas also discovered that his own sister perceived some coloured letters, while his mother and brother had some mirror-touch-like experiences.
Scientists now think we are all born with synaesthesia. A recent study found babies associate different shapes with different colours, however, this merging of senses diminishes in most people as our brains remove unnecessary connections in a process known as "pruning".
prune【他動】～を切り取る、刈り取る、刈り込む
"One hypothesis is people with synaesthesia have a defect in pruning so end up with an excess of connections," Salinas says.
Now a neurologist at Harvard Medical School and Massachusetts General Hospital, Salinas has found it easier to talk about his experiences as research into the subject has increased.
"Earlier there had been the risk of being perceived as weird or different or a liar. Now I can defend it as something that is real," he says.
He agreed to be interviewed by artist Daria Martin, who was creating a film installation for the Wellcome Collection in London about mirror touch.
"We think people have five senses: sound, sight, smell, taste and touch. Beyond this there are several scientifically recognised senses including pain and temperature," Martin says.
"Synaesthesia can move between any of these crossings."
Martin created two films that explore the mirror-touch synaesthete's way of seeing. She interviewed a number of people with the condition and introduced Salinas to one of them - Fiona Torrance from Liverpool.
"Our experiences were surprisingly similar, though she seemed to have been more overwhelmed by some of her physical experiences," Salinas says.
"For example, there was an incident where she was sitting in her car, someone nearby was suddenly punched, and it sounded like the mirrored experience was so physical and vivid that it triggered a fainting spell."
fainting spells失神の発作
Salinas says that when synaesthetes meet and discover what symptoms they share they come away with a "greater sense of normal-ness".
However, he is keen that synaesthesia should not be thought of as a disorder.
"I don't see it as a blessing or a curse as it can be both," he says.
"I couldn't imagine my life without synaesthesia. I wouldn't be who I am now without it."
 

20180405

Brain back-up firm Nectome loses link to MIT
Nectome aims to preserve biomolecules in the brain to let memories be saved after death
A company attempting to map people's brains so their memories can be stored in computers has lost its link to one of the United States' top universities.
biomolecule【名】《化学》生（体）分子
lose a link to～とのつながりをなくす［が切れる
US start-up Nectome revealed its brain back-up plan last month, warning at the time that the process involved would be "100% fatal".
start-up【形】〔会社などが〕創業したばかりの、設立当初の、生まれたての
A number of neuroscientists subsequently poured scorn on the plan.
pour scorn on（人）を嘲る［軽蔑する・さげすむ］、（人）に冷笑［嘲りの言葉・軽蔑の言葉］を浴びせる
subsequently【副】その後（に）、後に、その次に、それ以降、後で、続いて
The Massachusetts Institute of Technology (MIT) has now announced that it is severing ties with the project.
One of the university's professors had previously benefitted from a federal grant given to Nectome and was attempting to combine its work with his own research into mouse brains.
federal grant連邦補助金
"Neuroscience has not sufficiently advanced to the point where we know whether any brain preservation method is powerful enough to preserve all the different kinds of biomolecules related to memory and the mind," said the MIT in a blog explaining its decision.
Nectome has responded saying: "We appreciate the help MIT has given us, understand their choice, and wish them the best."
'Potential to benefit humanity'
The university's in-house publication MIT Technology Review had been first to draw attention to Nectome's plans and the educational establishment's own involvement.
It has since reported that the collaboration had attracted "sharp criticism" from experts in the field, who feared it lent credibility to an effort that was doomed to fail.
credibility【名】信頼性、信ぴょう性、真実性
"Fundamentally, the company is based on a proposition that is just false," said Sten Linnarsson of the Karolinska Institute in Sweden.
"[And there's a risk] some people actually kill themselves to donate their brains."
Nectome had previously said that it believed it would one day be possible to survey connectome - the neural connections within the brain - to such a detailed degree that it would be able to reconstruct a person's memories.
コネクトーム（connectome）とは、生物の神経系内の各要素（ニューロン、ニューロン群、領野など）の間の詳細な接続状態を表した地図、つまり神経回路の地図のこと。 つながる、接続するといった意味を持つ英語のコネクト（connect）という言葉と、「全体」を表す-オーム（-ome）という接尾語から作られた言葉。
In order to achieve this, the brain must be preserved at point of death - a process called vitrifixation.
vitrificationガラス(状)化、ガラス化されたもの
Some experts have cast doubt over whether memories can be extracted from dead brain tissue
MIT Technology Review had reported that the firm was soon hoping to test its theories on the head of someone planning a doctor-assisted suicide.
However, Nectome has acknowledged that its work is at a relatively early stage.
"We believe that clinical human brain preservation has immense potential to benefit humanity, but only if it is developed in the light, with input from medical and neuroscience experts," it said in a statement posted to its website.
"We believe that rushing to apply vitrifixation today would be extremely irresponsible and hurt eventual adoption of a validated protocol."
validated protocol有効プロトコル
Despite the sceptics, Nectome has won a $960,000 (￡687,000) grant from the US National Institute of Mental Health.
sceptics懐疑的な
It is also backed by Y Combinator, a high-profile Silicon Valley-based funder that previously invested in Dropbox, Airbnb and Reddit among others.

20180403

Giving Babies Antibiotics or Antacids May Increase Allergy Risk
Babies given antibiotics or antacids in infancy may be at increased risk for allergies in childhood.
antacid【名】〔胃の〕制酸薬 胃酸を中和する働きのあるマグネシアや重炭酸ソーダなど。
Researchers retrospectively studied 792,130 infants covered by a health insurance program. Of these, 131,708 received antibiotics, 60,209 got histamine-2 receptor antagonists and 13,687 were given proton pump inhibitors. Both H2 blockers and P.P.I.s are prescribed for gastroesophageal reflex, or GERD.
retrospectively【副】さかのぼって、遡及的に
health insurance program健康保険プログラム
histamine-2 receptor antagonist ヒスタミンH2受容体拮抗剤 胃酸分泌抑制作用を有する 胃潰瘍・十二指腸潰瘍といった消化性潰瘍の治療に用いられる医薬品である。その作用機序は胃の壁細胞に存在し胃酸分泌を促進するヒスタミンH2受容体を競合的に拮抗することである。ヒスタミンH2受容体拮抗薬は胃の壁細胞にあるヒスタミンH2受容体を競合的に拮抗する。これにより平時の胃酸の分泌および食物による胃酸の分泌の双方を抑制する。これには2通りのしくみがあると考えられている。ヒスタミンがH2受容体に結合するのを妨げるのと、ガストリンやアセチルコリンの持つ胃酸分泌刺激作用が弱まるということである。
proton pump inhibitorプロトンポンプ阻害薬【略】PPIプロトンポンプを活性化する酵素（H+/K+-ATPase）の阻害物質
は胃の壁細胞のプロトンポンプに作用し、胃酸の分泌を抑制する薬である。胃酸分泌抑制作用を持つ薬剤には他にヒスタミンH2受容体拮抗薬（H2ブロッカー）があるがプロトンポンプ阻害薬はH2ブロッカーよりも強力な胃酸分泌抑制作用を持ち、分泌抑制作用は用量に依存する。H2ブロッカーよりも抑制作用が長時間持続する。
gastroesophageal reflex胃食道逆流症
The study, in JAMA Pediatrics, followed the children for an average of four and a half years. It found that infants given H2 blockers or P.P.I.s were more than twice as likely to have a food allergy as those who were not; the risk was especially high for allergy to cow’s milk. Those given antibiotics were at a 14 percent increased risk for food allergy, a 51 percent increased risk for anaphylaxis (a potentially fatal type of allergic reaction), and more than double the risk for asthma.
The authors suggest that both antacids and antibiotics disrupt the normal intestinal bacteria and that this may explain the association.
“Let's not prescribe these medicines for things that are very common in babies,” said the senior author, Dr. Cade M. Nylund, an associate professor of pediatrics at the Uniformed Services University. “Just because a baby spits up doesn’t mean that it’s a disease that requires treatment with a P.P.I. And we have to avoid overprescribing antibiotics for upper respiratory infections and other viral illnesses.”
spit up吐き出す

20180402

Tesla in fatal California crash was on Autopilot
Electric carmaker Tesla says a vehicle involved in a fatal crash in California was in Autopilot mode, raising further questions about the safety of self-driving technology.
One of the company's Model X cars crashed into a roadside barrier and caught fire on 23 March.
Tesla says Autopilot was engaged at the time of the accident involving the driver, 38, who died soon afterwards.
But they did not say whether the system had detected the concrete barrier.
"The driver had received several visual and one audible hands-on warning earlier in the drive," a statement on the company's website said.
"The driver's hands were not detected on the wheel for six seconds prior to the collision."
"The driver had about five seconds and 150m (490ft) of unobstructed view of the concrete divider... but the vehicle logs show that no action was taken," the statement added.
unobstructed【形】遮るもののない、妨げられていない、邪魔のない
Tesla's Autopilot system does some of the things a fully autonomous machine can do. It can brake, accelerate and steer by itself under certain conditions, but it is classified as a driver assistance system, is not intended to operate independently and as such the driver is meant to have their hands on the wheel at all times.
In 2016, a Tesla driver was killed in Florida when his car failed to spot a lorry crossing its path.
It led the company to introduce new safety measures, including turning off Autopilot and bringing the car to a halt if the driver lets go of the wheel for too long.
let go of～から手を放す
Federal investigators said last year that Tesla "lacked understanding" of the semi-autonomous Autopilot's limitations.
Earlier this month, Uber was forbidden from resuming self-driving tests in the US state of Arizona.
It followed a fatal crash in the state in which an autonomous vehicle hit a woman who was walking her bike across the road.
It was thought to be the first time an autonomous car had been involved in a fatal collision with a pedestrian.
The company suspended all self-driving tests in North America after the accident.

20180401

Hospitals 'failing' on genetic bowel cancer test
Stephen Sutton had Lynch syndrome and died of bowel cancer aged 19 in 2014
More than 80% of NHS hospitals in England are failing to test bowel cancer patients for the genetic condition Lynch syndrome, according to the charity Bowel Cancer UK.
Lynch Syndromeリンチ症候群 遺伝性非ポリポーシス大腸がんの別名 常染色体優性の遺伝的素因による大腸癌である。発癌リスクの上昇はDNAミスマッチ修復酵素の変異による。
The condition increases the risk of bowel and other cancers.
Bowel Cancer UK estimates that 166,000 people in the UK are unaware that they have the condition.
An NHS England spokeswoman said there are clear guidelines about when it is appropriate to test for Lynch syndrome.
Testing for the syndrome can guide the treatment of the patient and indicates whether their families are at risk.
Children of people with the condition have a 50/50 chance of developing it.
The charity says it is important to find out whether patients have Lynch syndrome, because some chemotherapy drugs are ineffective for them.
And if other family members find they have the syndrome then it enables them to take steps to reduce their risk of bowel cancer, or be diagnosed at an earlier stage when it is easier to treat.
Teenage cancer fundraiser Stephen Sutton, who died of bowel cancer at 19, had Lynch syndrome. His father had twice battled bowel cancer.
fund-raiser【名】〔資金集めの〕イベント、大会、パーティー〔資金集めの〕担当者、組織
When Stephen presented with similar symptoms he was told he was too young to get the disease, delaying his diagnosis for six months.
Lynch syndrome
Lynch syndrome (LS) is also known as hereditary non-polyposis colorectal cancer (HNPCC)
polyposis【名】ポリープ症
It is caused by an alteration in a gene called a mismatch repair gene
LS doesn't cause any symptoms
LS increases your lifetime risk of bowel cancer by up to 80%, and also of developing many other cancers including ovarian, stomach and womb
If your family has a history of developing these cancers when they are under 50 years old, it is possible they have the altered gene that causes LS
Knowing about the risk and having regular screening may help prevent some cancers. It may also help other cancers be found in the early stages, when they are more likely to be curable
People with LS are screened every two years - some people with LS even remove part of their bowels or wombs to pre-empt potential cancers
The National Institute for Health and Care Excellence (NICE) guidelines recommend testing all bowel cancer patients for Lynch syndrome at the time of their diagnosis.

20180331

Buying Viagra: What you should know
Men can now buy the impotence pill Viagra Connect without a prescription at some UK pharmacies.
Health experts hope it will mean more men get help for erectile dysfunction - a condition thought to affect up to one in five adult men, 4.3 million in the UK.
Like any medication though, the drug can cause side-effects and should not be misused or abused.
What should men consider before buying and trying the little blue pills?
Who can have it?
Viagra Connect is only for men who have impotence.
No-one under the age of 18 can buy it, although women might be able to buy it on behalf of their partner if the pharmacist is satisfied it is appropriate to dispense it.
And it will not be sold to men who are not medically fit enough to have sex. This includes men with severe heart or blood vessel problems.
As a rule of thumb, men who become very breathless or experience chest pain when doing light exercise, such as climbing two flights of stairs, should not take these pills.
As a rule of thumb 経験からいって
flight【名】〔階段の〕一続き 階と階（または踊り場）との間の一続きの階段
Can it be bought off the shelf?
No. You will need to ask the pharmacist for it, who will then check it is safe for you to take.
A packet of four pills will cost ￡19.99.
Do men wanting to buy have to talk to someone and be examined?
You can ask at the pharmacy counter for a quiet word or to have a conversation in a private room if they prefer - most pharmacies now have private consultation facilities.
The pharmacist will ask about symptoms, general health, and any other medications you might be taking. They should not ask personal questions about your sex life or sexual preferences.
You should not need a physical examination.
Will it work?
In many cases yes, but it is not effective for everyone.
The drug relaxes the blood vessels in the penis to help blood flow and will help achieve an erection in response to sexual stimulation.
It can be taken with or without food, although it may take a little longer to start working if you have just had a big meal.
You should take it about an hour before you plan to have sex.
Do not take it with grapefruit or grapefruit juice, because this can affect how the medicine works.
And do not take more than one 50mg tablet per day.
If it has been some time since you were able to get or keep an erection, it may take a couple of attempts before you are able to achieve one.
Drinking lots of alcohol can also make it more difficult to get an erection.
What if it is too strong?
Talk to your pharmacist or doctor if you think it is too strong - the drug's effects last too long or are too powerful.
Prolonged and sometimes painful erections lasting longer than four hours have been occasionally reported by men taking the drug.
Although unlikely, if this does happen, seek immediate medical assistance.
What other side-effects might there be?
Very common (may affect more than one in 10 people):
headache
Common (may affect up to one in 10):
dizziness
colour tinge to vision or blurred vision - some people start seeing a blue hue
hot flushes
blocked nose
nausea
Stop taking the pills and seek immediate medical attention if you have a serious side-effect such as:
chest pain
sudden decrease or loss of vision
an allergic reaction (eg difficulty breathing, wheeze and swelling of the lips, eyelids or face)
a seizure or fit
Drug clashes
People on nitrate pills for angina should not take Viagra Connect. That also goes for people taking recreational poppers (amyl nitrite).
angina【名】《病理》アンギナ、咽喉痛口狭炎などの、心疾患以外でけいれん性の激しい痛みを伴う病気。《病理》狭心症
amyl nitrite主に狭心症等の心臓疾患に使われる薬品であり、薬理効果としては同じ強心剤のニトログリセリンや亜硝酸ナトリウムとほぼ同じとされている
There is also a clash with a medicine called riociguat and an HIV medication called ritonavir.
Make sure you tell the pharmacists about any treatments you are taking so they can check it will be safe for you to also have Viagra Connect.
Pharmacists should advise men to book a follow-up appointment with their doctor within six months of starting on Viagra Connect because erectile dysfunction can sometimes be a sign of other underlying conditions, including heart disease, high cholesterol and diabetes.
Can I get it anywhere else?
GPs can prescribe it. And some pharmacies will be selling it online, after a virtual consultation.
Always check that the seller is reputable. Drugs from unregulated sellers may be fake, ineffective and unsafe.
reputable【形】評判の良い、信頼できる

20180330

Girl, six, died after doctor 'failed to spot meningitis'
A six-year-old girl died after a doctor missed a "classic indicator" that she had meningitis, an inquest heard.
meningitis
【名】
《病理》髄膜炎
髄膜（脳および脊髄を覆う保護膜）に炎症が生じた状態である 炎症はウイルスや細菌をはじめとする微生物感染に起因 項部硬直であり、発熱や錯乱、変性意識状態、嘔吐、光を嫌がる（羞明）、騒音に耐えられなくなる（音恐怖）などといった症状を伴う。また、ビオー呼吸と呼ばれる、間欠的に無呼吸の時間が現れる特殊な呼吸の状態が一時的に見られる場合もある。小児例では不機嫌や傾眠などの非特異的症状が目立つものの、大泉門が閉鎖していない場合は膨らむことがある。ほとんどはウイルスによるもので、次いで細菌、真菌、原生動物によるものが多い
Layla Rose Ermenekli was taken to Royal Oldham Hospital with a high temperature, leg and stomach pains and a tell-tale rash on her hip, and died eight hours later.
Dr Harsha Rajanna said he asked her mother Kirsty about the hip mark and was told she bumped into a table.
Mrs Ermenekli said the exchange never happened.
The hearing was told that Layla, from Oldham, Greater Manchester, was a lively girl who loved playing with her friends and dancing. She became ill in February last year and was taken to the hospital's accident and emergency department.
She was triaged as "priority two" at 20:55 GMT and should have been seen by a doctor within 10 minutes, but Dr Rajanna did not see her until 22:50 GMT.
Mrs Ermenekli told the inquest he said Layla could go home and she felt pressured to take her.
feel pressuredストレスを感じる、圧力を感じる、脅威を感じるImage caption
A nurse called in junior doctor Imogen Buck who saw the non-blanching rash - a "classic indicator" of meningitis.
Layla was transferred to a high dependency unit but died of meningococcal meningitis and septicaemia hours later.
meningococcal【形】髄膜炎菌性の
Dr Rajanna told the inquest he noticed Layla's hip mark and thought it was a bruise, but made no note of it.
When asked why, he said Mrs Ermenekli had told him the child had bumped into a table, which she denies.
He said she wanted to take Layla home but he recommended she be seen by the paediatric team.
A lawyer representing Layla's family said: "Either your recollection is wrong or you are giving dishonest evidence to this court."
The coroner asked Dr Buck why she did not challenge Dr Rajanna after Layla died and she said felt it "wasn't appropriate".
 

20180329

Man has 'world's worst' super-gonorrhoea
A man in the UK has caught the world's "worst-ever" case of super-gonorrhoea.
He had a regular partner in the UK, but picked up the superbug after a sexual encounter with a woman in south-east Asia.
Public Health England says it is the first time the infection cannot be cured with first choice antibiotics.
Health officials are now tracing any other sexual partners of the man, who has not been identified, in an attempt to contain the infection's spread.
He picked up the infection earlier in the year.
The main antibiotic treatment - a combination of azithromycin and ceftriaxone - has failed to treat the disease.
azithromycin【名】アジスロマイシンマクロライド系抗生物質 15員環に窒素原子が入っているという構造に由来
ceftriaxone【名】《化学》セフトリアキソン
Dr Gwenda Hughes, from Public Health England, said: "This is the first time a case has displayed such high-level resistance to both of these drugs and to most other commonly used antibiotics."
Discussions with the World Health Organization and the European Centres for Disease Control agree this is a world first.
What is gonorrhoea?
gonorrhoea【名】《病理》淋病 淋は「淋しい」という意味ではなく、雨の林の中で木々の葉からポタポタと雨がしたたり落ちるイメージを表現したものである。
The disease is caused by the bacterium called Neisseria gonorrhoeae.
The infection is spread by unprotected vaginal, oral and anal sex.
Of those infected, about one in 10 heterosexual men and more than three-quarters of women, and gay men, have no easily recognisable symptoms.
But symptoms can include a thick green or yellow discharge from sexual organs, pain when urinating and bleeding between periods.
Untreated infection can lead to infertility, pelvic inflammatory disease and can be passed on to a child during pregnancy.
Analysis of the man's infection suggests one last antibiotic could work. He is currently being treated and doctors will see if it has been successful next month.
So far no other cases - including in the British partner - have been discovered, but the investigation is still under way.
Dr Hughes added: "We are following up this case to ensure that the infection was effectively treated with other options and the risk of any onward transmission is minimised."
Doctors have long been warning this could happen.
In 2015, there was an outbreak of azithromycin-resistant gonorrhoea centred on Leeds.
The fear is the bug could eventually become untreatable by any antibiotic.
Dr Olwen Williams, the president of the British Association for Sexual Health and HIV said: "The emergence of this new strain of highly resistant gonorrhoea is of huge concern and is a significant development.
"We are concerned that the problem will worsen due to the dramatic cuts that have been delivered to the public health budget.
"Worryingly this has left sexual health services at 'tipping point', with clinic closures coming at the worst possible time."
 

20180328

Magician Dynamo opens up about Crohn's struggle
Magician Dynamo has said medication for Crohn's disease has caused his recent change in appearance.
Crohn's disease
クローン病、炎症性腸疾患 主として口腔から肛門までの全消化管に、非連続性の慢性肉芽腫性炎症を生じる原因不明の炎症性疾患 遺伝的な素因を持ち、免疫系の異常（主としてマクロファージが腫瘍壊死因子αというサイトカインを分泌して腸壁の正常細胞を傷害すること）がおこり、その上で食事因子などの環境的な因子が関係しているのではないかと考えられている。
サイトカイン(cytokine) とは、免疫システムの細胞から分泌されるタンパク質で、標的細胞は特定されない情報伝達をするものをいう。多くの種類があるが特に免疫、炎症に関係したものが多い。また細胞の増殖、分化、細胞死、あるいは創傷治癒などに関係するものがある。ホルモンと似ているが、ホルモンは分泌する臓器があり、比較的低分子のペプチドが多い。しかし、サイトカインとホルモンは、はっきりとした区別があるものではなく、エリスロポエチン (erythropoietin) やレプチン (leptin) など両方に分類されることがある。また、リンパ球に由来するサイトカインを、リンフォカイン (lymphokine) ということが多い。一部は医薬品として用いられている。
Dynamo, whose real name is Steven Frayne, posted a video on his social media accounts explaining he became "really sick" in 2017.
Frayne said his medication regime since then has caused him to "put on quite a lot of body weight" and develop a rash.
medication regimen薬物投与計画
rash【名】発疹
He said he is also unable to shuffle cards because his hands are in "so much pain" due to developing arthritis.
Frayne also thanked people for their "kind support," following a selfie he posted online on Monday evening showing the change in his appearance, including the extent of the rash on his head.

"I've been keeping a bit more of a low profile as I got really sick and ended up in hospital last summer due to a really bad type of food poisoning - which having Crohn's disease and food poisoning very bad combination," he said in the video.
low profile【名】低姿勢（をとる人［こと］）、控えめな態度［姿勢］、目立たないこと［存在・人・態度］
keep a low profile 低姿勢［控えめな態度］を保つ、目立たないでいる、目立つ行動を控える
food poisoning食中毒
"Thankfully the NHS worked amazingly well to get me out of hospital and back on my feet... I'm doing everything in my power to get myself better."
But others shared their experiences of Crohn's disease and the corticosteroid drugs often used to treat the illness.
What is Crohn's disease?
It's a long-term health condition affecting any part of the digestive system, but usually the small or large intestine.
The bowel lining gets inflamed, causing symptoms that can include diarrhoea, abdominal pain and blood and mucus in your poo.
bowel lining腸の内層
Doctors do not know what causes it - the disease can flare up after even long periods of remission.
flare up【句動】〔問題・病気などが〕急に起こる
There's currently no cure, but treatments, such as steroids, can help alleviate the inflammation.
It's thought about 115,000 people in the UK have Crohn's.
Hundreds of people suffering with Crohn's sent messages of support to Dynamo, who spoke to The Sun in December 2017 about living with the illness, after recognising the star's weight gain as a common side effect of medication.

A number of people coping with Crohn's pointed out weight gain, water retention and steroid rash as common side effects.
water retention水貯留
Many others praised the performer for raising awareness of the illness, and admonishing those making unsupportive comments.
admonish【他動】〔悪いことをした人を〕叱る〔人に〕諭す、戒める、訓戒する
Kate told the BBC she instantly recognised the side effects of steroids and "knew exactly what the photo was all about".

"You only understand the effect of the drug if you have Crohn's.
"We Crohn's sufferers call it 'Moonface'.
ステロイドの長期間大量使用や副腎皮質ホルモンの一種である糖質コルチコイドの過剰分泌による脂肪沈着から、満月様となった顔貌をいう。同時に皮膚が薄くなり循環血漿量が低下し皮下の毛細血管が透けるため赤ら顔（多血症）となったり、皮脂腺の活動が亢進して 瘡を生じて、しばしば口囲などに多毛症を伴う。肩に脂肪が沈着して野牛肩（バッファローハンプ）を生じたりする。クッシング症候群、副腎皮質ホルモンを大量、長期間服用している患者に典型的にみられる。ムーンフェイスや丸顔とも呼ばれる。満月様顔貌を引き起こすステロイド薬の種類には喘息などの治療に使われるプレドニゾロンやデキサメタゾンがある。
"I last had a flare up about a year ago, and I was on prednisolone for six months. I put on two stone in that time."
Kate says a lack of understanding of Crohn's disease leads many people to make "vile" and offensive comments.
Kate describes the side effects of the steroid treatments as "horrendous".
"You feel like people are talking about you when the way you look changes. That makes you feel even worse than you already do."

20180327

Tuberculosis rates in England fall by third in six years
New figures show rates of tuberculosis (TB) in England have declined by a third in six years, and are currently at their lowest level in 35 years.
decrease by a third3分の1減少する
The data from Public Health England shows a 38% fall since 2012, with a 9.3% decline in cases in 2017 alone.
Improved diagnosis, treatment and awareness are being credited for the fall.
credited for 《be ～》に対して功績がある
But England still has one of the highest rates of TB in Western Europe with just under 5,200 affected in 2017.
And TB is still one of the leading causes of death worldwide.
The data has been released to coincide with World TB Day on 24 March.
The World Health Organization's campaign Light up the World for TB will see buildings and landmarks across the world lit up in red across the weekend 23-25 March.
It's hoped it will highlight the continued focus that is required to meet the ultimate ambition of making England TB-free.
Dr Sarah Anderson, head of the National TB Office at Public Health England, said: "People often think that TB is a Victorian disease that is no longer a problem in England, but in fact it still affects over 5,000 people a year and there is still a lot to do until the target to eliminate TB is met.
"We urge everyone to join the fight to confine TB to history. World TB Day is an opportunity for people everywhere to be informed about TB, educate others and urge governments to take action. This global movement will make a powerful statement and show solidarity for people who have been affected by TB."
Tuberculosis facts
TB is a bacterial infection spread through inhaling tiny droplets from the coughs or sneezes of an infected person
It mainly affects the lungs, but it can affect any part of the body, including the tummy (abdomen) glands, bones and nervous system
The most common symptoms of TB are a persistent cough for more than three weeks, unexplained weight loss, fever and night sweats.
TB is difficult to catch and you need to spend many hours in close contact with a person with infectious TB to be at risk of infection
TB can be fatal if left untreated - but can be cured if it's treated with the right antibiotics over a course of six months
The BCG vaccine offers protection against TB, and is recommended for babies, children and adults under the age of 35 who are at risk of catching TB
At-risk groups include: children living in areas with high rates of TB and people with close family members from countries with high TB rates
The most recent data on infection rates show parts of London still have higher rates of TB than some developing countries, such as Iraq, Libya and even Yemen.
London is known as the TB capital of Western Europe and has seen initiatives such as a mobile clinic taking to the capital's streets to test vulnerable people, such as the homeless.
Free testing and treatment of latent TB is available in England for people from areas where TB is common.
TB breakthrough
Last year researchers in Oxford and Birmingham reported they had made a world-first breakthrough in the diagnosis of tuberculosis.
They managed to isolate different strains of the disease using a process called genome sequencing.
genome sequencing《遺伝》ゲノム解読［配列決定］
It means patients who may have waited months to get the right drugs can now be diagnosed in only a few days - so they have a greater chance of recovery.
While figures have gone down over the last six years in England, another issue in the battle to eradicate TB is drug resistance.
A recent study found one in five global cases of the disease is now resistant to at least one major treatment drug.

20180326

Hamelin Bay: Nearly 150 beached whales die in Australia
Only six whales have survived a mass stranding of pilot whales on the coast of Western Australia.
pilot whale
《動物》ゴンドウクジラ［イルカ］クジラ目マイルカ科ゴンドウクジラ属（Globicephala）の、ヒレナガゴンドウ（long-finned pilot whale）とコビレゴンドウ（short-finned pilot whale）の2種類のイルカまたはクジラ。【語源】群れで泳ぐときに、一頭が先頭を泳いで先導している様子から、名付けられたとされる。
About 150 of the animals were found beached at Hamelin Bay, about 300km (180 miles) south of Perth.
Their discovery by a local fisherman on Friday prompted a major rescue effort to return them to deeper waters.
However, by nightfall, more than 140 of the whales had died, with deteriorating weather conditions and the threat of frenzied sharks impeding efforts.
frenzied【形】ひどく興奮した
More than 100 volunteers, wildlife personnel and others came to the aid of the beached pilot whales, a species known to strand en masse.
en masse【副】〈フランス語〉〔人々の行動が〕集団で、大挙して
"I've never seen anything like it, seen so many whales beached like this," one tourist told the Associated Press news agency.
"Unfortunately, most of the whales beached themselves on dry land overnight [on Thursday] and have not survived," Parks and Wildlife Service spokesperson Jeremy Chick said in a statement.
Are whales attempting suicide when they beach themselves?
Why a New Zealand beach strands so many whales
The rocky beach terrain, dead whales surrounding the survivors and rough seas were challenging factors in moving the surviving whales, officials said.
Mr Chick said there was a risk the surviving whales might come back into shore and re-strand.
"This has often been the case in previous mass strandings," he added.
'A mystery of nature'
Scientists do not know exactly what causes whales to beach themselves.
Experts have said stranding can occur when whales are sick or injured, or make navigational errors, particularly along gentle sloping beaches.
"It's one of the mysteries of nature," one of the rescue coordinators told the Sydney Morning Herald, adding that "once they come ashore like that they do deteriorate quite quickly."
Sometimes beached animals can send out distress signals that attract other whales to become stranded.
In 1996, about 320 whales became beached in Western Australia's largest stranding.

20180325

Woman dies after having bee-sting therapy
A woman has died after undergoing bee-sting therapy, a form of treatment backed by Gwyneth Paltrow.

The 55-year-old Spanish woman had been having live bee acupuncture for two years when she developed a severe reaction.
acupuncture【名】鍼、鍼治療、鍼療法、刺鍼法
She died weeks later of multiple organ failure.
Researchers who studied the case say live bee acupuncture therapy is "unsafe and unadvisable".
It is thought to be the first death due to the treatment of someone who was previously tolerant of the stings.
The woman's case has been reported in the Journal of Investigational Allergology and Clinical Immunology, by doctors from the allergy division of University Hospital, Madrid.
She had been having the treatment once a month for two years at a private clinic to improve muscular contractures and stress.
During a session, she developed wheezing, shortness of breath, and sudden loss of consciousness immediately after a live bee sting.
wheezing【名】喘鳴
She was given steroid medication but no adrenaline was available, and it took 30 minutes for an ambulance to arrive.The woman had no history of any other diseases like asthma or heart disease, or other risk factors, or any previous allergic reactions.
What is apitherapy?
apitherapy【名】アピセラピー、ハチ療法、ミツバチ療法 ハチの毒液や、蜂蜜やローヤルゼリー、プロポリス、花粉などの生産物を利用する治療法。ラテン語のapis（ハチ）とtherapyを合わせた造語。
Apitherapy is the use of substances from honeybees, such as honey, propolis, royal jelly, or even venom (extracted or from live bees), to relieve various medical conditions. One type of apitherapy is live bee acupuncture.
propolis【名】蜂ろう
Although some benefits of apitherapy have been reported, they have mainly been anecdotal.
anecdotal【形】逸話の、逸話的な〔話などが〕裏付けに乏しい
Bee-venom therapy has been used for treating conditions including arthritis and MS.
The theory behind the treatment is that bee stings cause inflammation leading to an anti-inflammatory response by the immune system.
anti-inflammatory response 抗炎症性反応
But the Multiple Sclerosis Trust says "there is no research to show it is an effective treatment for people with MS". They said a 2008 review of non-conventional approaches to treating MS found that there was only marginal evidence for bee-venom therapy.
marginal【形】余白［欄外］に書かれた〔場所が〕周辺部の、縁にある〔地理的に〕隣接する〔程度や重要性が〕わずかな、取るに足りない
In an interview with the New York Times in 2016 Gwyneth Paltrow said she had tried apitherapy.
"I've been stung by bees. It's a thousands-of years-old treatment called apitherapy. People use it to get rid of inflammation and scarring. It's actually pretty incredible if you research it. But, man, it's painful."
And on her wellbeing website Goop she says she was "given 'bee-venom therapy' for an old injury and it disappeared".
Last year, Gerard Butler revealed he had been injected with bee sting venom to try to help reduce inflammation from stunt work. He ended up in hospital after he was injected with the venom of 23 bees. He said he felt like his heart might explode and as if he had ants under his skin.
The doctors found severe anaphylaxis had caused a massive stroke and permanent coma with multiple organ failure.
The report's authors called for:
Patients to be fully informed of the dangers of apitherapy before undergoing treatment
Measures to identify sensitised patients at risk should be implemented before each apitherapy sting
sensitized【形】感作された
identify families at risk 危険性［リスク］のある家系を特定して
Apitherapy practitioners should be trained in managing severe reactions
Apitherapy practitioners should be able to ensure they perform their techniques in a safe environment
They should have adequate facilities for management of anaphylaxis and rapid access to an intensive care unit
But they acknowledged that because the treatment often takes place in private clinics, these measures may not be possible.
One of the report's authors Ricardo Madrigal-Burgaleta concluded: "The risks of undergoing apitherapy may exceed the presumed benefits, leading us to conclude that this practice is both unsafe and unadvisable."
Amena Warner, Head of Clinical Services for Allergy UK, said:
"The public need to be very aware of the unorthodox use of allergens such as bee venom. This will come with risk and, in susceptible individuals, can lead to serious life threatening reactions."

20180324

MS drug hope for secondary-progressive stage
A study of a new drug to treat advanced cases of multiple sclerosis suggests it may be possible to delay progression of the disease in the short term, although the effects were small.
In a trial of 1,327 people, in The Lancet, 26% saw their disability worsen after three months taking siponimod compared with 32% taking a dummy drug.
No drugs currently exist for secondary-progressive multiple sclerosis.
An MS expert expressed caution, saying other new treatments were still needed.
About 100,000 people in the UK have MS - a lifelong, progressive condition. Most are diagnosed between the ages of 20 and 70.
MS affects the central nervous system and can cause problems with:
vision
balance
fatigue
stiffness
memory
Most cases start as relapsing-remitting MS and most of these develop into secondary-progressive MS within 15-20 years.
relapsing-remitting form of MS再発寛解型MS
'Modest effect'
Patients in this trial, which was funded by drug company Novartis, had had MS for an average of 17 years - four years with secondary MS, the advanced stage.
Most needed assistance with walking before the trial began.
When standard measures of disability were used to track their progress, there was a 21% lower risk of walking or arm movements getting worse for those given the drug, compared with those taking the placebo.
But the international research team found the drug had no effect on maintaining patients' walking speed and it had some side-effects, although it was still thought to be safe.
Lead author Prof Ludwig Kappos, from the University of Basel, said: "Although the results are not as good as we wanted to see, it is a very large study, which is robust.
"It means siponimod is one option to delay the disease in the advanced stage."
Dr Susan Kohlhaas, director of research at the MS Society, said: "These results bring us closer to the first ever treatment for people with secondary-progressive MS - so it's big news.
"This trial showed that siponimod had a modest but significant effect in slowing disability progression, which is incredibly encouraging."
'Disappointing'
But Dr Luanne Metz, from the University of Calgary, in Canada, said a second trial was needed to confirm the benefits of the drug and its impact beyond three to six months.
She said: "Although siponimod seems to reduce the time to confirmed disability in secondary-progressive MS, the treatment effect was small.
"In our opinion... the absence of a significant difference for the key secondary clinical outcome are disappointing results and do not suggest that siponimod is an effective treatment for secondary-progressive MS."
She added: "Trials of other novel treatments that target non-inflammatory mechanisms are still needed."
Before the drug becomes available on the NHS, it would need to be approved by the European Medicines Agency and then recommended as cost-effective by bodies in the UK.
cost-effective【形】費用［コスト］効率［効果］の高い［良い］、費用対効果の良い

20180323

Tai chi recommended to fight fibromyalgia
Tai Chi【名】太極拳
fibromyalgia【名】線維筋痛 全身の骨格筋に激しい痛みやこわばりが生じるリウマチ性疾患である。新興疾患では無く、以前は「非関節性リウマチ」「心因性リウマチ」「軟部組織性リウマチ」「結合組織炎」「結合組織炎症候群」などと呼ばれていた。
線維筋痛症は、英語でFibromyaligia Syndromes　腱や靭帯を意味するFibroと、筋肉を意味すMioが「痛い」ことに由来しています。
Tai chi is as good as - or even better than - aerobic exercise for aiding people with the chronic pain condition fibromyalgia, a study has suggested.
The US trial of 226 adults with the condition showed that those who practised the martial art improved significantly more than those doing aerobic exercise over a 24-week period.
martial art《a ～》武道、武術、マーシャル・アーツ
Its low-impact movements mean people of any age or fitness level can take part.
Aerobic exercise is currently a standard treatment for the condition.
But some patients find it hard to do because their symptoms keep changing.
Fibromyalgia is a long-term condition that causes pain all over the body and can also lead to increased sensitivity to pain, fatigue, muscle stiffness, memory problems and sleeping difficulties.
Aerobic exercises such as walking, cycling and swimming, together with resistance and strengthening exercises, like lifting weights, are recommended to help people who have been diagnosed.
But this study, published in the British Medical Journal, says the findings suggest "it may be time to rethink what type of exercise is most effective for patients".
"Tai chi mind-body treatment results in similar or greater improvement in symptoms than aerobic exercise, the current most commonly prescribed non-drug treatment," the authors said.
"This mind-body approach may be considered a therapeutic option in the multi-disciplinary management of fibromyalgia."
multidisciplinary【形】多くの専門分野にわたる
disciplinary【形】訓練の、鍛錬のための規律上の学問の、専門分野の
The adults taking part in the study had not participated in tai chi or other similar types of complementary and alternative medicine in the previous six months.
complementary medicine〈主に英〉補完医学［医薬品］
Their average age was 52 they had suffered body pain for an average of nine years and 92% of participants were women, with 61% being white.
They were each randomly assigned to either supervised aerobic exercise twice a week for 24 weeks or to one of four supervised tai chi sessions of 12 or 24 weeks, completed once or twice each week.
Changes in their symptom scores were assessed at 12, 24 and 52 weeks and participants continued taking their regular medicines and made their usual visits to their doctors.
While scores improved in all areas, the combined tai chi patients showed significant improvement at the 24-week stage, although there was little difference whether they did it once or twice a week.
The effects of tai chi were consistent across all the instructors and nobody suffered any serious adverse effects.
The researchers did say there were some limitations in their study - participants were aware of their treatment group assignment and attendance at sessions differed between the two forms of exercise.
However, they said that key strengths of their research were that it featured a large and diverse sample of people and had a longer follow-up than previous studies.
A guide to tai chi
Tai chi combines deep breathing and relaxation with flowing movements
Studies have shown that it helps people aged 65 and over to reduce stress, improve posture, balance and mobility and increase leg muscle strength
Some research shows it can reduce the risk of falls
There is some evidence it can improve mobility in the ankle, hip and knee in people with rheumatoid arthritis
Nobody is too old or unfit to take up tai chi
Tai chi is characterised by its slow, graceful, continuous movements - many of which are completed with bent knees in a squat-like position

The findings of the study have come as no surprise to some experts.
Mark Peters, a senior tai chi instructor and executive committee member of the Tai Chi Union for Great Britain, told the BBC: "It is a low-impact exercise and movements are steady and circular, and in terms of physical rehab at a hospital, it is a graded exercise - meaning it builds up progressively as ability builds up.
"Aerobics is high-impact but tai chi also increases heart rate and core strength, only with no impact problems.
"The NHS are big advocates and I've been teaching tai chi for patient rehab to NHS staff for 10-to-15 years or more and run courses like how to use it for brain injury and stroke recovery. I've been involved in quite a lot of studies which show it helps rebuild brain pathways."
Des Quinn, chairman of the Fibromyalgia Association, told the BBC: "It is no surprise to us that tai chi can be of help to people with fibromyalgia.
"There have been some pilot studies in the past that have suggested that it could benefit people with fibro. Its gentle approach to increasing activity is something that would be easier for sufferers than running, for example.
"However, what works for one person will not necessarily work for another in the same way. Someone with fibromyalgia faces a journey to find a balance of treatments and changes that improves their own quality of life.
"Increasing levels of activity is what we would tend to say when talking about exercise."

20180321

Macular degeneration: 'I've been given my sight back'
macular degeneration黄斑変性
脈絡膜から発生する新生血管と呼ばれる異常な血管（脈絡膜新生血管）を伴うタイプ（老人性円板状黄斑変性）と、新生血管を伴わないタイプに大別されます。網膜に栄養を送っている脈絡膜からブルッフ膜を通り、網膜色素上皮細胞の下や上にのびる新しい血管のことです。これは正常な血管ではないので、血液の成分が漏れやすく、破れて出血をおこしてしまいます。 
Doctors have taken a major step towards curing the most common form of blindness in the UK - age-related macular degeneration.
Douglas Waters, 86, could not see out of his right eye, but "I can now read the newspaper" with it, he says.
He was one of two patients given pioneering stem cell therapy at Moorfields Eye Hospital in London.
Cells from a human embryo were grown into a patch that was delicately inserted into the back of the eye.
'Couldn't see anything'
Douglas, who is from London, developed severe age-related macular degeneration in his right eye three years ago.
The macula is the part of the eye that allows you to see straight ahead - whether to recognise faces, watch TV or read a book.
whether to～するかどうか
He says: "In the months before the operation my sight was really poor and I couldn't see anything out of my right eye.
"It's brilliant what the team have done and I feel so lucky to have been given my sight back."
The macula is made up of rods and cones that sense light and behind those are a layer of nourishing cells called the retinal pigment epithelium.
retinal pigment epithelium網膜色素上皮
layer of rods and cones杆錐状体層
When this support layer fails, it causes macular degeneration and blindness.
Doctors have devised a way of building a new retinal pigment epithelium and surgically implanting it into the eye.
The technique, published in Nature Biotechnology, starts with embryonic stem cells. These are a special type of cell that can become any other in the human body.
They are converted into the type of cell that makes up the retinal pigment epithelium and embedded into a scaffold to hold them in place.
scaffold【名】《建築》足場
The living patch is only one layer of cells thick - about 40 microns - and 6mm long and 4mm wide.
It is then placed underneath the rods and cones in the back of the eye. The operation takes up to two hours.
'Incredibly exciting'
Prof Lyndon da Cruz, consultant retinal surgeon at Moorfields, told the BBC: "We've restored vision where there was none.
"It's incredibly exciting. As you get older, parts of you stop working and for the first time we've been able to take a cell and make it into a specific part of the eye that's failing and put it back in the eye and get vision back."
However, he does not call this a "cure" as completely normal vision is not restored.
Only one diseased eye was operated on in each patient.
So far the patients, the other is a woman in her early sixties, have maintained improved vision in the treated eye for a year.
They went from not being able to read with their affected eye at all, to reading 60 to 80 words per minute.
Eight more patients will take part in this clinical trial.
Doctors need to be sure it is safe. One concern is the transplanted cells could become cancerous, although there have been no such signs so far.
Prof Pete Coffey, from the UCL Institute of Ophthalmology, said: "This study represents real progress in regenerative medicine.
"We hope this will lead to an affordable 'off-the-shelf' therapy that could be made available to NHS patients within the next five years."
More than 600,000 people have age-related macular degeneration in the UK. It's the leading cause of blindness and the third globally.
Both patients in the trial had "wet" age-related macular degeneration.
This form of the disease is caused by abnormal blood vessels growing through the retinal pigment epithelium and damaging the macula.
Dry age-related macular degeneration is more common and caused by the retinal pigment epithelium breaking down.
It is hoped the patch will be able to treat both forms of the disease.
Dr Carmel Toomes, from Leeds Institutes of Molecular Medicine, said: "What's exciting about this study is that the patients recorded an increase in vision.
"To see an improvement is a good sign that this therapy may help patients in the future, although further studies are needed before real conclusions can be drawn."