The risk of getting gout has a lot to do with our genes and little to do with diet, says GP Ayo Ajanaku. Plus, sufferers Kevin Hughes and Jared West on drugs that have helped them

Daniel Lavelle is mentions that gout was historically called “the rich man’s disease” (At 35, I found out I had gout. Imagine having to give up everything you like to eat and drink, 29 November). It was also known as “the disease of kings”, but we now know that its main similarity with royalty is a predilection for certain genes. Lavelle’s article was enjoyable, but perpetuates the misconception that gout is fundamentally a lifestyle disease. This misconception can lead to shame and stigma for some patients.

Research has relatively recently confirmed that the association between diet and gout is far weaker than previously thought. The underlying driver of gout is uric acid crystals in the joints. There is evidence that diet accounts for no more than 1% of the variation in uric acid levels between people. In contrast, genetics has a tremendously greater impact on the risk of developing gout than any other risk factor. Moreover, well-meaning dietary rules can be burdensome and confusing.

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After months in intensive care, Cesar Franco became the first person in Britain to have the operation because of the virus

“When I woke up I was confused. I remembered the doctors in St George’s hospital deciding to intubate me. But when I woke up from the intubation, I’d been transferred to another hospital, St Thomas’, and was on a machine that was keeping me alive. I wondered how things had gotten so bad and how I’d gone from being just ill to being, you know, very close to dying.”

Cesar Franco is reliving how he fell gravely ill with Covid-19 late last year and ended up in the intensive care unit (ICU) of St Thomas’ hospital in central London, helpless, struggling to breathe and only still alive thanks to the quiet pumping of an extracorporeal membrane oxygenation (Ecmo) machine. It was the start of what became five arduous, precarious months in ICU on Ecmo. That is an unusually long time, even for a Covid patient, to receive what, for some but not all, proves to be life-saving care.

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Experts have seen an increase in the number of children using melatonin. What do we know about the ‘hormone of darkness’?

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Taking melatonin used to be the habit of the jet-lagged traveller as a way to shortcut the weary bewilderment of a confused body clock. Then it was discovered by parents. “Pretty much all the kids I see, by the time they get to me, they’ve used melatonin,” says Dr Chris Seton, a paediatric sleep physician at the Woolcock Institute and the children’s hospital at Westmead in Sydney.

Melatonin is a hormone produced by the brain’s pineal gland in response to darkness; its nickname is the hormone of darkness. Levels increase at night, which helps precipitate sleepiness through its interactions with the central clock and circadian rhythm, then decrease towards dawn, precipitating wakefulness.

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Cesar Franco is the first person in the UK to undergo a double lung transplant as a result of a Covid-19 infection. He spent five months in St Thomas' hospital on the NHS's highest level of live support, with an Ecmo machine effectively breathing for him. When doctors told him his only chance of survival was to have a transplant, he was transferred to Harefield hospital for the operation. Now, after several months of an arduous recovery programme, he is able to breathe normally and walk again

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For decades public health authorities have encouraged us to choose healthier foods – yet most choices available to Americans are bad ones

Diet-related chronic disease is the perennial number one killer in the United States, responsible for more deaths than Covid-19 even at the pandemic’s peak. Yet we cannot manage to define this as a “crisis”. In fact, our response is lame: for decades we’ve been telling people to “eat better”, a strategy that hasn’t worked, and never will.

It cannot, as long as the majority of calories we produce are unhealthy. It is the availability of and access to types of food that determines our diets, and those, in turn, are factors of agricultural policy. For a healthy population, we must mandate or at least incentivize growing real food for nutrition, not cheap meat and corn and soya beans for junk food.

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Triage system eConsult was supposed to improve patient care but UK surgeries are having to switch it off for periods as demand soars

An online consultation platform widely used by GP surgeries and promoted as being available “around the clock” is being turned off by some practices for most of the day because of high demand.

The eConsult platform is used in more than 3,000 GP practices in England, Scotland and Wales to help direct patients to the care they need. The online facility, offered to about 28 million patients, is described in promotional material as “available to use any time, day or night, from any device connected to the internet”.

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Billy Liar’s loose grasp on reality is common today but experts say it is less benign. That is, if you believe them

Billy Liar, created in the 1950s, is a fantasist; a teller of tall tales who lives much of his time in the imaginary world of Ambrosia.

He is engaged to two girls and fancies a third. He is desperate to get out of the dead-end town of Stradhoughton where he lives with his working-class family and where he has secreted 211 “luxury” calendars under his bed that he should have posted nine months before, on behalf of his employers, Shadrack & Duxbury, “funeral furnishers”.

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Lab-grown nerve cells will replace those destroyed by disease – scientists hope treatment may be available in five years

Early next year, a radical new treatment for Parkinson’s disease involving tissue transplants will receive its first trial with patients – including a group from the UK.

Stem cells grown in the laboratory and transformed into nerve cells will be used to replace those destroyed by the disease. It is hoped that these will stop the spread of debilitating symptoms.

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Dean Burns urges other parents with any concerns about their children's health to get them checked.

A special body suit for people with cerebral palsy, multiple sclerosis and strokes has had some remarkable results.

Another UK child has died from this highly contagious infection. What should people look out for?

Scientists did the study for the government to better understand possible exposure to shoppers.

Whistleblowers allege they were punished for raising concerns at one of England's worst performing trusts.

When ambulance crews bring patients to hospital they are meant to be able to handover their patients to A&E staff within 15 minutes.

Woman, 85, endured "agonising" wait as BBC analysis shows delays now at record levels.

Two doctors say they experienced "every parent's worst nightmare" when their son got sick.

Members of two unions have backed walkouts across England and Wales as the NHS pay dispute deepens.

Lecanemab is the first drug to remove damage, but there are questions around its impact, side effects and use.

Why is bird flu so bad this year and why are scientists so concerned?

The Human Fertilisation and Embryology Authority finds a lack of Asian egg and black sperm donors.