A case report published in the Journal of Neuroinflammation gives hope to patients with Alzheimer's disease and their carers. Rapid cognitive improvement was seen within minutes in a patient with late-onset Alzheimer's disease following perispinal etanercept (an anti-TNF drug). Previous research has suggested that excess tumour necrosis factor-alpha (TNF-alpha) is centrally involved in the pathogenesis of Alzheimer's disease. It has recently been shown to mediate the disruption in synaptic memory mechanisms, which is caused by beta-amyloid and beta-amyloid oligomers. The beneficial effects seen with etanercept may be related to amelioration of the effects of excess TNF-alpha on synpatic mechanisms in Alzheimer's disease.

The Tooke report into the Modernising Medical Careers (MMC) debacle was published today and calls for a new national and independent organisation, NHS Medical Education England, to oversee the training and career development of junior doctors and to work with the government on workforce planning. The inquiry chairman, Sir John Tooke, is showing one way forward after the unprecedented disaster in spring 2007 which saw the government's attempts to reform postgraduate medical education and recruitment to specialist training posts descend into farce. However what happens to the doctors still suffering the consequences of the 2007 recruitment round and the doctors about to suffer in the 2008 round remains to be seen. The report, Aspiring to Excellence, acknowledges the problem but may have come too late to save them.