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S. Korea reports first foot-and-mouth case for 3 years

South Korea on Thursday confirmed its first case of foot-and-mouth in more than three years, and just two months after the country was declared free of the disease.

The Agriculture Ministry said in a statement that the case had been confirmed in a pig farm in Uiseong in the eastern province of North Gyeongsang.

"A close examination confirmed an outbreak of FMD at the Uiseong farm," the statement said.

South Korea had just regained its status as an FMD-free country in May at a meeting of the World Organisation for Animal Health in Paris.

The entire Korean peninsula suffered a devastating outbreak in 2011 that resulted in the culling of nearly 3.5 million cattle, pigs and other animals in South Korea alone.

The Seoul government estimated the cost of that outbreak at $2.6 billion.

Foot-and-mouth disease affects cloven-hoofed animals such as cattle, pigs, deer, goats and sheep.

North Korea suffered an outbreak in February this year, triggering a rare offer of vaccine and medical equipment from the South.

Illegal bottom injections on rise in US

Natalie Johnson suffered after she received illegal injections

A growing number of American women are getting plastic surgery to enhance their behinds. But with the costs running into the thousands of dollars, many are choosing cheap, illegal and life-threatening backstreet procedures.

She did it because she thought she'd look better, and be more desirable.

But getting injections for a bigger behind was the biggest mistake Natalie Johnson ever made.

At her home in a Miami suburb, she shows me pictures of her scarred body, bruised and blackened from decaying tissue.

"I didn't need it, I was perfect without it," she says. "I was in a lifestyle where I felt if I had a big old butt and I could make more money."

The pain she has to endure is so severe that it is hard for her to sit down for too long. Johnson relies on her nine-year-old daughter to help with the most basic of tasks.

Johnson was working as an exotic dancer when she met someone claiming to be a doctor who offered to perform a buttocks-enhancement procedure at a fraction of the price of a registered surgeon.

Natalie JohnsonJohnson says her body deteriorated years after the injection

It did not seem out of the ordinary. Other friends had it done and plenty of young women in Miami desire a larger behind to look like the dancers in music videos, Johnson says.

She says a man named O'Neal Morris came to her house wearing white scrubs - "looking professional" - and injected a substance into her behind using plastic syringe.

At first the results were good: a firmer, rounder rear, bringing her closer to her goal of a "Coca-Cola bottle-shaped body".

She had two more rounds of treatment. Soon after, the problems began.

"It started making me really, really sick. I noticed it was starting to disintegrate and my butt turned wrinkly," she says.

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Bottom's up

Syringe injecting into a

Surgical attention to the backside is on the rise. In 2013:

2,438 people got a buttock lift, an 80% increase over 2000.

7,281 people received a "lower body lift", which includes shaping the buttocks, thighs, hips and abdomen. That represents 3,417% increase over 2000 and the biggest growth measured by the American Society of Plastic Surgeons.

942 people got buttock implants, compared to 858 in 2012. Rates were not measured in 2000.

9,993 people in the US got a buttock augmentation with fat grafting, compared to 8,654 in 2012.

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"I was getting dizzy, and feeling fatigued."

On one occasion Johnson was rushed to hospital after she stopped breathing.

Morris began a one-year jail sentence in January for practicing medicine without a licence.

Women who came forward during the trial said Morris, who is not a qualified doctor, had injected them with a range of substances including cement, superglue and tyre sealant.

The Federal Bureau of Investigations says the numbers of cases of people posing as fake doctors to perform this kind of treatment are on the rise, especially in Florida, New York, California and Texas.

At his surgery in a Miami suburb, Dr Alberto Gallerani shows me vials containing things he has pulled out of patients' buttocks, including olive oil and super glue.

A certified plastic surgeon, Gallerani has been treating Johnson and hundreds of other women and men who come to him for corrective surgery after botched procedures.

Doctor Alberto Gallerani Dr Gallerani says he suspects shame is keeping more women from coming forward

He shows me photos of what can go wrong. They are too horrific to post online, but in some cases the skin has changed colour and is badly scarred. Other more extreme images show how the body has become severely disfigured.

Gallerani says in many cases the symptoms can take several years to appear.

"What many of the people doing this don't realise is, they're putting a ticking time bomb in their body," he says.

He says he gets 100 calls a week from people asking for help.

Buttocks are an increasing target for surgical enhancement. In 2013, the numbers for this procedure doubled on the previous year, according to the American Association of Aesthetic Plastic Surgeons. It costs thousands of dollars to get it done properly, which is why many women are opting for cheaper, unregulated methods.

Hip-hop culture celebrates a larger rear, and the pressure on women to have a bigger behind is huge, says Tee Ali, a London-based casting agent.

Claudia AderotimiClaudia Aderotimi died after an injected substance spread to her organs

His client and friend, 20-year-old Claudia Aderotimi, died in 2011 after she flew from London to Philadelphia to get injections from a woman she met online. Doctors believe the illegal silicone shots spread to her organs, killing her. The person accused of administering the procedure is due in court next year.

Ali says Aderotimi believed a bigger behind would help her make it in the music industry.

"When girls go out and one of them has a big rear, she gets all the attention. She'll get everything, free lifts, free drinks," he says. "It's well known, girls with bigger bums have more attention and they have big jobs and they're more in demand."

Ali says young women to whom he has spoken are afraid to discuss the issue openly, and won't admit they might want to get surgery in the first place, which also drives many to underground procedures. He says many women fly to the US to get the injections because they are harder to find in the UK.

Tragically, Aderotimi is not alive to warn others of the dangers, but Johnson believes by sharing her story she can save others from the same fate.

"Stick with what God gave you," she says.

"I tell girls, if it ain't broke don't fix it. You are beautiful the way you are."

Journal raises concern about blood-thinning drug

A medical journal raised concerns Wednesday about a blood-thinning drug widely used by people at risk of stroke, accusing its manufacturer of concealing safety data and regulators of laxness.

A key selling point of the drug known as Dabigatran or Pradaxa was that it required no blood-level monitoring, as does competitor warfarin.

Dabigatran's maker, Boehringer Ingelheim, had said the drug was better than warfarin at reducing stroke in people with irregular heart rhythm, with a similar risk of major bleeds, according to the British Medical Journal (BMJ).

Based on its own probe, the journal accused Boehringer of concealing information that blood-level monitoring could in fact reduce major bleeds by up to 30-40 percent compared to warfarin.

"The BMJ has found that neither doctors nor regulators have ever been aware of these calculations," said a statement.

Irregular heart rhythm (atrial fibrillation) affects about 800,000 Britons and over three million Americans.

According to BMJ investigations editor Deborah Cohen, who conducted the research, millions of people take the anti-clotting drug, with blood levels found to vary greatly between patients.

"These analyses suggest that dabigatran could be made safer," she told AFP by email.

A one-off test may be sufficient to check how a particular patient was reacting to the drug, which seeks to keep the blood thin enough to protect against stroke, but not so thin to pose a major bleed risk.

The BMJ said the US Food and Drug Administration (FDA) and European Medicines Agency (EMA), in 2010 and 2011 respectively, approved the drug without the need for blood tests, despite concerns.

"Once licensed, dabigatran proved a financial success, but by the end of 2011 concerns about fatal bleeds were beginning to emerge," it wrote.

In May, the manufacturer settled for $650 million (480 million euros) in 4,000 cases in the United States linked to use of its blood-thinner.

The FDA told AFP its approval of the drug had been based on information supplied by Boehringer.

"The FDA is constantly examining product labelling to make sure the label reflects the current knowledge with regard to the benefits and risks of the product," the agency said, adding it had published "several" drug safety tips about Pradaxa over the years.

The EMA said it was evaluating whether any relevant information had not been submitted.

"In case of any new evidence, the EMA will take action as necessary to guarantee the safety of patients," it said.

Boehringer UK in a tweet advised patients not to stop taking the drug, but consult their doctor if they were concerned.

"We remain confident in our medicine's benefits and safety profile which have been reaffirmed by the European Medicines Agency (EMA), the US Food and Drug Administration (FDA) and others," it tweeted.

Paracetamol no better than placebo in low-back pain

Paracetamol, the first-choice lower-back pain killer, worked no better than dummy drugs administered in a trial of more than 1,600 people suffering from the condition, researchers said Thursday.

In fact, the median recovery time for those on placebo was a day shorter than that for trial subjects given real medicine, they wrote in The Lancet medical journal.

"Our findings suggest that... paracetamol does not affect recovery time compared with placebo in low-back pain, and question the universal endorsement of paracetamol in this patient group," the Australian team concluded.

"Paracetamol also had no effect on pain, disability, function, global symptom change, sleep or quality of life."

Lower-back pain is the leading cause of disability in the world, and paracetamol is "universally" recommended as the treatment of first choice, said a statement carried by The Lancet.

The Paracetamol for Low-Back Pain Study (PACE) divided 1,652 individuals with acute pain from 235 clinics in Sydney, Australia, into three trial groups.

One group received regular paracetamol doses, the other used the drug as needed, and the third was given placebo pills.

Recovery was defined as seven consecutive days of 0 or 1 pain intensity on a 0-10 scale.

"Median time to recovery was 17 days in the regular paracetamol group, 17 days in the as-needed paracetamol group, and 16 days in the placebo group," said the statement.

All patients were given high-quality advise and reassurance, and the findings suggest these may be more important in lower-back pain management than drug therapy, said the authors.

"Our results convey the need to reconsider the universal endorsement of paracetamol in clinical practice guidelines as first-line care for low-back pain."

A potential limitation of the study was that some participants used other treatments.

In a comment also carried by The Lancet, Bart Koes and Wendy Enthoven from the Universal Medical Center in Rotterdam applauded the team "for tackling this research question on a topic that has been without debate and evidence for such a long time."

But they cautioned that guidelines should not be changed on the basis of a single trial.

Warning over NHS trust finances

Healthcare team of nurses and doctors

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Nineteen NHS trusts have been referred to ministers after auditors raised concerns about their financial health.

The Audit Commission made the move after reviewing the health of 98 trusts running a combination of hospital, ambulance and community services.

The referrals have been made because the trusts have failed to break even and do not have robust enough plans to balance the books in the coming years.

The number represents nearly a four-fold rise from five last year.

It is another sign of the growing financial problems being seen in the health service. Earlier this month the Nuffield Trust warned that a quarter of trusts had finished the year in deficit, but that included nearly 250 trusts across the whole health service.

The Audit Commission looked in-depth at only those trusts that have not achieved foundation trusts status - given to the elite performers - and, as such, they tend to be the most financially-challenged organisations.

'Worrying'

Overall the watchdog had concerns about a third, but the 19 who got referrals are effectively the ones with the most deeply-rooted problems.

Not only did they fail to break even in 2013-14, but they were unable to convince auditors they could rectify the issues in the medium term.

The referral to Health Secretary Jeremy Hunt means the trusts will face closer scrutiny from the authorities.

Audit Commission controller Marcine Waterman said the findings were "worrying".

A Department of Health spokesman said the government recognised there were challenges which was why the budget had been protected this parliament.

He added: "It is essential that trust chief executives have a tight financial grip and ensure they live within their means."

The 19 trusts are: Barking, Havering and Redbridge University Hospitals NHS Trust; Barnet and Chase Farm Hospitals NHS Trust; Epsom and St Helier University Hospitals NHS Trust; George Eliot Hospital NHS Trust; Hinchingbrooke Health Care NHS Trust; Ipswich Hospital NHS Trust; Leeds Teaching Hospitals NHS Trust; Mid Essex Hospital Services NHS Trust; Mid Yorkshire Hospitals NHS Trust; North Bristol NHS Trust; North Cumbria University Hospitals NHS Trust; North West London Hospitals NHS Trust; Shrewsbury and Telford Hospital NHS Trust; Surrey and Sussex Healthcare NHS Trust; The Princess Alexandra Hospital NHS Trust; United Lincolnshire Hospitals NHS Trust; University Hospital of North Staffordshire NHS Trust; Weston Area Health NHS Trust; Worcestershire Acute Hospitals NHS Trust.

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