Guinness 0.0: a miracle!

Non credo ai miracoli ne ho visti troppi (I do not believe in miracles; I have seen too many of them).

Oscar Wilde, Irish Poet/Playwright. (1854–1900) Fig. 1.

Fig. 1: Oscar Wilde.

Public domain. Elliott and Fry 1881.

As an Irishman, the thought of Guinness without alcohol seems to be an abomination. However, it can, and has been, done successfully. It is called Guinness 0.0, and I tasted it Fig. 2 and its OK. Several years ago, Guinness tried to market Guiness with a reduced alcohol content. The central message was: ‘They said it could never be done.’ They were correct and the ‘Guinness Light’ was a flop! Louise Eccles, writing in the Sunday Times [1] extols the merits of Guinness 0.0 and the procedure used to extract the alcohol. This is quite a costly process and goes some to explain the cost of Guinness 0.0 even in countries where non-alcoholic beverages are not subject to high levels of government tax [2].

Fig. 2: A glass of Guinness 0.0.

Photograph Brenda Moore-McCann.

I don’t think Diagio (owners of Guinness) market wines, at least in Ireland. I remember the days before political correctness (PC) when Guiness was offered in Maternity hospitals in Ireland to breast-feeding mothers. The ploy was that Guinness contained a lot of iron. Perhaps it does! At that time my wife was in hospital giving birth to our first child. She did not like Guinness. I went to see her every day and happily consumed her ration. Alas PC rules the day now and I no longer father children. The practise of serving Guiness to breast-feeding mothers is a distant memory.

Whatever about Guinness 0.0, who would ever have thought of English sparkling wine rivalling champagne? I have alluded to this on a number of occasions [3] but Lizze Enfield, writing for the BBC [4] in September 2024, points out that the hard work of a number of wine farmers has eventually paid off, due in part to climate change. English sparkling wine is so good that a number of the large Champagne houses are purchasing land in the UK for the development of vineyards, Pomery, Tattinger and California-based Jackson Family Wines among others. As she points out: It was the Romans who first brought grape vines to Britain 2000 years ago. The Normans also successfully established viticulture 1000 years later, but viticulture declined in the Middle Ages. And despite a flurry of interest sparked by 18th-Century adventurers, it was not until the 1970s that an English winemaking renaissance truly began.

Have there been changes in haematology? Yes. Of the first 200 patients who received an allogeneic Bone Marrow Transplant there were no long-term survivors. Thanks to the dogged perseverance of E Donnal Thomas and his colleagues and the discovery of the HL-A system, together with improvements in supportive care the situation is now much more satisfactory.

Atsuta and colleagues in an article in Haematologica [5] Point out that the use of HCT doubled in about a decade worldwide at different speed and with significant changes regarding donor match as a sign of improved access to HCT worldwide. Although narrowing, significant gaps remain between developing and non-developing countries. Unfortunately, but not surprisingly, access to HCT is greater in countries with a high GNI (gross national income per capita).

The latest EBMT Newsletter reports that over 10,000 CAR-T infusions have been reported to the registry. CAR T-cell therapy and other cellular immunotherapies are advanced therapy medicinal products (ATMPs) manufactured from human primary living cells procured by hospitals or blood banks. CAR T-cell therapy is a highly personalised medicine administered to the patient in one treatment, as opposed to other forms of immunotherapies such as bispecific antibodies which are administered sequentially over prolonged periods of time. Long-term follow-up is needed to demonstrate the sustainability of safety and effectiveness of the treatment [6].

Immunotherapy, usually as an adjunct to chemotherapy, has a definitive role to play in the treatment of haematological malignancies. As well as increasing the efficacy of some chemotherapeutic regimens, immunotherapy helps to decrease acute toxicity. Over time the precise role of immunotherapy in the treatment of haematological malignancies will undoubtedly will be accurately defined and its use will increase.

Although I am not a surgeon, the field of keyhole and robotic surgery have greatly reduced toxicity and facilitated much shorter times in hospital than traditional methods. This is particularly true of methods which traditionally would have involved opening the omentum.

Changes are occurring in the worlds of wine and medicine. Hopefully you will be able to benefit from changes in wine and not have to avail of changes in medicine.

As this is my last editorial, I wish you all well. I have thoroughly enjoyed writing them and hope you enjoyed reading them. With best wishes,

Shaun McCann.