Tamiflu: was it a fraud?

Hello everyone! A long overdue update on my blog. Today I want to share with you this piece of news about medication for the flu. This is an excuse to see some medical vocabulary! Once again, Thanks to the wonderful journalists at BBC for their wonderful articles... and wonderful English!

Here's the link: http://www.bbc.co.uk/news/health-26954482

BBC News Health 10 April 2014

Tamiflu: Millions wasted on flu drug, claims major report 

By James Gallagher Health and science reporter, BBC News 

Hundreds of millions of pounds may have been wasted on a drug for flu that works no better than paracetamol, a landmark analysis has said.

1. To waste (something) on (something): to spend money or time unnecesarily on something.
2. Flu: everyday name in English for "Influenza" a very common illness similar to but stronger than the common cold. The most common symptoms are fever (higher than usual body temperature), congestion, sneezing and coughing.
3. Drug: as in spanish this word has usually a negative connotation. However in English there are two classes of drugs: prescription drugs, which are prescribed by doctors to their patients and "recreational drugs" which people take with the aim to enjoy themselves including "legal drugs" like tobacco and alcohol.
4. To claim: to say something. It is often used to insinuate that what has been said may not be true.
5. Landmark: usually about buildings or monuments that become a reference for people, e.g. the Eiffel Tower or the Big Ben. However when some event is really relevant and changes the previous situation, it is also called a landmark. 

The UK has spent £473m on Tamiflu, which is stockpiled by governments globally to prepare for flu pandemics. The Cochrane Collaboration claimed the drug did not prevent the spread of flu or reduce dangerous complications, and only slightly helped symptoms. The manufacturers Roche and other experts say the analysis is flawed. The antiviral drug Tamiflu was stockpiled from 2006 in the UK when some agencies were predicting that a pandemic of bird flu could kill up to 750,000 people in Britain. Similar decisions were made in other countries.

1. To stockpile: to pile (to accumulate) in order to create a stock (reserves).
2. Spread: (verb and noun) to spread means to extend something over some surface or space. Spread is also the abstract noun for this concept, for example the spread of an illness in a country.
3. slightly: slight is an adjectives that means something is superficial or not strong. For example if you have some information about something, you can have a "slight idea". Slightly is the adverb from this adjective.

Hidden data 

The drug was widely prescribed during the swine flu outbreak in 2009. Drug companies do not publish all their research data. This report is the result of a colossal fight for the previously hidden data into the effectiveness and side-effects of Tamiflu. It concluded that the drug reduced the persistence of flu symptoms from seven days to 6.3 days in adults and to 5.8 days in children. But the report's authors said drugs such as paracetamol could have a similar impact. On claims that the drug prevented complications such as pneumonia developing, Cochrane suggested the trials were so poor there was "no visible effect".

1. Hidden: not visible.
2. Widely: generally, not only in specific conditions or specific places.
3. prescribed: to prescribe is what doctors do with medicines. They will write a document which is the prescription. This document says which medicine you have to take, how often and what the dosage is (how much of it each time).
4. swine flu: Swine is an old-fashioned term to refer to pigs (the farm animals) and other wild animals of the same or similar species, like the wild boar. Since this kind of flu originated in these animals, that is why it was given this name. Swine is also a term used by women to refer to men who are disloyal or unfaithful to their women. If a man is simply unhygienic, then they will be called pigs.
5. Outbreak: noun from the verb to break out, meaning the explosive start of a massive infection in a population group, e.g. the flu. in contrast with a normal situation when the illness occurs ocassionally and its spread (see above) is controlled and very slow.
6. Effectiveness: the capacity to generate a desired effect. For example to cure an illness or control the symptoms.
7. Side-effects: unexpected effects of something (usually medication) that happen with no intention or by accident and usually are negative.
8. To conclude: to reach a conclusion after thinking or investigating something.
9. On claims that: in connection with those claims (see above "to claim").
10. Trials: a trial is a process to determine if something is true or false (legal trials) or if it is effective and safe (medical trials). 

Another justification for stockpiling was to slow the spread of the disease to give time for a vaccine to be developed. The report's authors said "the case for this is simply unproven" and "there is no credible way these drugs could prevent a pandemic". It also claimed that the drug had a number of side-effects, including nausea, headaches, psychiatric events, kidney problems and hyperglycaemia.

1. To slow: to reduce the speed.
2. For a vaccine to be developed: this is a sentence in the passive voice. Vaccines and other drugs are developed (=medical scientists develop vaccines and other drugs) - To develop: to create following a process.
3. The case for this is simply unproven: "case" is a word often used in "legal English" to refer to the reasons to defend a position in court. Here the sentence means: there is no proof (no evidence) to believe this is true.
4. Headaches: "Ache" and "pain" are the two main words in English to describe the physical signal you get when something is wrong in your body. "Ache" is usually combined in the same word with organs or clearly defined parts of your body like "headache", "toothache". It also usually refers to dull, recurring or cronic situations. In contrast pain is usually something stronger, ocassional and atypical. For example you can say your legs "ache" (yes, it can be used as a verb) to describe the feeling after running or standing up for a long time. However if you have some traumatic situation such as an injury, you would say I have a pain in my leg. Is it clear now? I hope so... 
5. Kidneys: body organs (two) whose function is to filter body liquids and eliminate toxins. Located around the lower-back area.
6. Hyperglycaemia: a medical condition where the glucose-in-blood levels are too high. 

Carl Heneghan, Professor of Evidence-Based Medicine at the University of Oxford and one of the report's authors, told the BBC: "I think the whole £500m has not benefited human health in any way and we may have harmed people. "The system that exists for producing evidence on drugs is so flawed and open to misuse that the public has been misled." Dr Tom Jefferson, a clinical epidemiologist and former GP, said: "I wouldn't give it for symptom relief, I'd give paracetamol."

1. To harm: to do something negative to someone or something. 
2. Flawed: imperfect, defective.
3. Misuse: incorrect or inadequate use.
4. Misled: adjective referring to people who have been affected by wrong instructions, directions or informations. It comes from the verb to mislead which means to guide someone in the wrong direction or make them come to the wrong conclusion.
5. relief: feeling of comfort after the symptoms of an illness or problem have disappeared.

The Cochrane Collaboration researchers have not placed the blame on any individual or organisation, instead saying there had been failings at every step from the manufacturers to the regulators and government.

1. To place (or put) the blame on (someone or something): to indicate that someone (not yourself) is responsible for something negative. e.g. In Spain politicians put the blame on each other for the country's problems, but they don't offer any solutions.
2. Failing: something has not been correctly done. For example food poisoning in a restaurant is a failing in hygiene controls in the kitchen.

'Wrong statistics' 

However, there is disagreement about the findings and accusations that a simultaneous campaign to open up drug research is influencing the findings.

The pharmaceutical company Roche said "we disagree with the overall conclusions" and warned they could "potentially have serious public health implications". Its UK medical director, Dr Daniel Thurley, told the BBC News website: "The definitive piece of research stands as the randomised control trials, which were shared with the regulators, which led to them in 100 countries around the world approving Tamiflu for treatment and prevention of flu."

1. Findings: information found during research, investigation or exploration.
2. overall: general.
3. Research: to try to find more about some issue such as science. Not to be confused with investigation, which is what the police and detectives do.
4. Randomised: set in a random (disorganized, chaotic) way. 

He said the Cochrane group had used the wrong statistics, which "systematically underestimate the benefits" of the drug, and used "unorthodox" methods to analyze the side-effects. He concluded: "One of the challenges we have here is actually knowing what they've done." Prof Wendy Barclay, who researches the influenza virus at Imperial College London, said reducing symptoms in children by 29 hours would be "pretty beneficial". She told the BBC: "Tamiflu works as well as any drug we have now or [that] is on the cards. "Yes, I think they should replenish the stockpile. What else can you do if a pandemic strikes? We won't have a vaccine for the first six months."

1. To underestimate: to predict a result which is finally higher than expected.
2. A challenge: some difficult activity that requires the best of your abilities or power.
3. As well as: in this sentence it is an "equality" comparison based on the adverb "well". Other meaning of as well as is "too". e.g. He brought his wife and children as well as his parents and his dogs.
4. To replenish: to make something full again after it has been emptied. In this case the reserves (stockpile) of Tamiflu.

She also questioned the validity of the research as it analysed the impact during seasonal flu: "If it works a little bit in season flu, the chances are they'll work quite a lot better in a pandemic situation and get more people back to school and work." Kevin McConway, a professor of applied statistics at the Open University, said it was an "impressive" piece of work. He said: "It is a potential limitation of this study that the work has been carried out alongside campaigning on access to trial data. "The writers of the review have a clear position in this controversy, and, although I personally do generally agree with their position, I feel it does at times lead to some confusion between reporting the results of the review of these particular drugs and commenting on the general position on access to and use of unpublished data."

1. Seasonal: that happens only in a specific season (winter, summer...)
2. The chances are: the probability of something happening is... 
3. quite a lot: you use quite when using an expression alone sounds too strong. In this case, to avoid saying a lot. So it means "a little less than a lot, but still a very positive result".
4. impressive: a positive adjective meaning something is admirable.
5. piece of work:
6. a review: an evaluation of something, often used in scientific research.
7. to lead: to guide someone or something in a specific direction, either physically or in a figurative sense.
8. position on access to and use of...: the key in this expression is "and". It coordinates two elements "access to unpublished data" and "use of unpublished data". Since the final part is common, english grammar rules allow to make the coordination in this way, avoiding the repetition of the final part. It sounds very strange for spanish people, but it is perfectly correct. 

The Department of Health, which took the lead for the UK, said Britain was recognised as "one of the best prepared countries in the world for a potential flu pandemic" and "our stockpile of antivirals is a key part of this. "We regularly review all published data and will consider the Cochrane review closely." The World Health Organization, which classes Tamiflu as an essential medicine, said: "We welcome a new and rigorous analysis of available data, and look forward to consideration of its findings after it appears."

1. Department of health: the equivalent of "ministry".
2. to take the lead: to be the first to take an initiative, in this case buying drugs against the flu.
3. A key part: a very important part