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Medical News & Updates
Nov 28
Skin implant to fight cancer developed
Scientists have developed an implant that inserts a cancer vaccine into the skin to destroy tumours without causing damage to any other part of the body.

Researchers from Harvard University said, it is the first "cancer vaccine" delivered in the form of a plastic implant that can attack and destroy tumours.

According to the study published in the journal Science Translational Medicine, the implant, a tiny disk, works by releasing chemicals that attract a specific type of immune cells called dendritic cells which are encouraged to fight and kill cancer cells.

Cancer cells are good at evading the immune system because the body does not recognise them as "foreign".

This study provides some useful insights into how we can effectively train the immune system to recognise and destroy cancer cells but most other studies have looked at removing immune cells from the body, reprogramming them to recognize the individual's cancer and then returning them.

Once inside, the immune cells are exposed to proteins found on the surface of the cancer cells to be targeted.

With this information, the dendritic cells move on to the lymph nodes where they tell another type of immune cell, known as T cells, to hunt down and kill the cancer cells.

In mice with skin cancer, the implant was shown to successfully eliminate the tumours, BBC reported.

The researchers believe such implants could one day be used alongside chemotherapy and surgery to eliminate melanoma tumours, the most serious form of skin cancer.

Nov 27
Global HIV Infections Down 17 Per Cent
A new report shows that global new HIV infection rates have fallen by 17 per cent and suggests that HIV prevention programmes are making a difference beyond the natural course of the HIV/AIDS epidemic.

2009 AIDS epidemic update was released on Tuesday by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) at a press conference in Shanghai.

The drop of 17 per cent reflects new data that shows in some parts of the world such as East Asia, the rate of new HIV infection has dropped by nearly 25 per cent from 2001 to 2008. In South and South East Asia it has dropped by 10 per cent, and in sub-Saharan Africa it has dropped by about 15 per cent, over the same period.

In Eastern Europe it has levelled off, while in some countries it looks like the new HIV infection rate is on the rise again.

Michel Sidibe, Executive Director of UNAIDS, spoke about the good and the bad news highlighted in the report.

"The good news is that we have evidence that the declines we are seeing are due, at least in part, to HIV prevention."

"However, the findings also show that prevention programming is often off the mark and that if we do a better job of getting resources and programmes to where they will make most impact, quicker progress can be made and more lives saved."

The report shows that globally more people are living with HIV than ever before; it has gone up from 31.1 million in 2001 to 35.8 million in 2008. And while this is partly due to increased population it is also due to life saving antiviral treatments, as suggested by the fact that AIDS-related deaths have declined by 10 per cent in the past five years as people have increasingly gained access to treatment which has saved estimated 2.9 million lives since it became available in 1996.

One area where increased availability of antiretrovirals has made a noticeable difference is in helping HIV-positive mothers not pass the infection on to their children, a move which in 2001 is thought to have prevented about 200,000 new infections in children, said the report.

Among countries highlighted as making considerable progress is Botswana, Southern Africa, where treatment coverage is now 80 per cent, AIDS-related deaths have more than halved in the last five years, and because their parents are living longer, there are fewer newly orphaned children.

However, Dr Margaret Chan, Director-General of the WHO called for significant further investment in HIV treatment.

"We cannot let this momentum wane. Now is the time to redouble our efforts, and save many more lives," she told the press.

The report also suggests that more progress is made where AIDS and HIV programmes are an integral part of social and welfare services.

Sidibe focused on this when he spoke to the press, "AIDS isolation must end," he said.

"Already research models are showing that HIV may have a significant impact on maternal mortality. Half of all maternal deaths in Botswana and South Africa are due to HIV. This tells us that we must work for a unified health approach bringing maternal and child health and HIV programmes as well as tuberculosis programmes together to work to achieve their common goal," explained Sidibe.

Among the items of not so good news is evidence that suggests the "face of the epidemic is changing" and that efforts to prevent it are not keeping pace with this shift.

The report cites the example of Eastern Europe and Central Asia, where at first the HIV/AIDS epidemic was confined to injecting drug users, but is now infecting their partners. In other parts of Asia there has been a similar shift from sex workers and injecting drug users to heterosexual couples.

Another area of increasing concern raised in the report is that HIV programmes are not designed for older people, and yet there is increasing evidence, for instance in sub-Saharan countries, that this part of the population may have a high rate of infection. It gives the example of Swaziland, where more than two thirds of HIV infections among adults are in people over the age of 25, but few prevention programmes target this group.

There also appears to be a trend in many countries toward reducing the proportion of the HIV/AIDS budget that is spent on prevention. For instance in Ghana the prevention budget was 43 per cent smaller in 2007 compared to 2005, and in Swaziland, despite 26 per cent of the population being infected with HIV, only 17 per cent of the country's total HIV/AIDS budget goes on prevention.

Some critics suggest that the amount of attention that is paid worldwide to HIV and AIDS is disproportionate to the size of the problem compared to other "silent killer" diseases such as pneumonia and diarrhoea, and perhaps another approach would be better, to improve healthcare systems overall, with HIV and AIDS as part of the package.

Nov 27
'Mental illness' gene identified
Scottish researchers have made a breakthrough as they identified a gene that could help explain the causes of mental illness.

The international team of scientists, led by experts at Edinburgh University, discovered the gene ABCA13 that may help create drugs to restore mental health in patients with psychiatric illness.

Lead researcher Douglas Blackwood, Professor of Psychiatric Genetics at Edinburgh University found that the gene was faulty more frequently in patients with mental illness, when compared to healthy people.

"This is an exciting step forward in our understanding of the underlying causes of some common mental illnesses. These risk genes could signpost new directions for treatments," the Scotsman quoted him as saying.

Dr Ben Pickard, part of the Edinburgh team, now of Strathclyde University, also said: "This study is the first to identify multiple points of DNA damage within a single gene that are linked with psychiatric illness.

"It strongly suggests that this gene may regulate an important part of brain function that is linked with these devastating disorders."

He continued: "There are several very interesting things that come from this work. The first is that we have got a gene and an inkling about what it might do.

"It seems to be responsible for transporting lipids - various types of fat molecules - around and we suppose that if it fails to transport one particular type, it could have a knock-on affect on a particular aspect of cell function or the way that cells communicate with one another.

"The second thing is the fact that we find these mutations in this gene cropping up in people with schizophrenia, bipolar disorder and depression."

Nov 26
Humans 'hear' through their skin
A study found that inaudible puffs of air delivered alongside certain sounds influenced what participants thought they were listening to.

Writing in the journal Nature, the team said the findings showed that audio and visual clues were not the only important factors in how people hear.

The findings may lead to better aids for the hard of hearing, experts said.

It is already well known that visual cues from a speaker's face can enhance or interfere with how a person hears what is being said.


If further research can show the same effect is observed when listening to everyday conversation in the 'real' world, then it could help improve hearing aids
Dr Ralph Holme
RNID

In the latest study, researchers at the University of British Columbia in Vancouver wanted to look at whether tactile sensations also affected how sounds are heard.

They compared sounds which when spoken are accompanied by a small inaudible breath of air, such as "pa" and "ta" with sounds which do not such as "ba" and "da".

At the same time, participants were given - or not - a small puff of air to the back of the hand or the neck.

They found that "ba" and "da", known as unaspirated sounds, were heard as the aspirated equivalents, "pa" and "ta", when presented alongside the puff of air.

Full picture

It suggests people also use tactile sensory information alongside other cues to decipher what is being said.

This additional knowledge in how a full picture of sound is built up could prove useful in the future development of communication aids for the hearing impaired, the researchers said.

Study leader Dr Bryan Gick said his team would now work to develop a hearing aid incorporating the findings.

"All we need is a pneumatic device that can produce air puffs aimed at the neck at the right times based on acoustic input into the hearing aid, and then a set of experiments to test the efficacy."

Dr Ralph Holme, director of biomedical research at the deaf and hard of hearing charity, RNID, said: "It is well known that visual cues, like lip reading, can really help people listen to speech if they have a hearing loss.

"However, some consonants such as b and p or t and d have the same lip pattern.

"The possibility that a small puff of air on the skin could help people distinguish between these consonants is fascinating.

Early conversations

"If further research can show the same effect is observed when listening to everyday conversation in the 'real' world, then it could help improve hearing aids."

Dr Deborah James, lead scientist for child and family at National Biomedical Research Unit in Hearing, said the sounds associated with "tiny puffs of air" help young children differentiate between the beginnings and ends of words.

"We are exploring the earliest development of auditory/visual speech perception in very young babies with hearing difficulties - perhaps we should be looking out for how the babies respond to the natural puffs of air that parents produce when they get up close to their baby during their earliest conversations."

Nov 26
Japanese encephalitis claims over 500 lives in India
The viral infection Japanese encephalitis has claimed more than 500 lives in Uttar Pradesh and Bihar so far this year, with children facing the brunt of the disease.

According to a union health ministry document, Uttar Pradesh is the worst affected with 23 of its districts having been declared endemic.

'Twenty-three districts of eastern Uttar Pradesh are endemic to Japanese encephalitis,' the document said, adding that till Nov 16 this year, 476 people have died due to the disease in the state.

In Bihar, the number of deaths is at least 30 this year. Over 140 are still undergoing treatment for this viral disease in the state. Besides Japanese encephalitis, both these states contribute over 90 percent of India's polio burden.

Domestic pigs and wild birds are reservoirs of the Japanese encephalitis virus. The virus is transmitted by infective bites of female mosquitoes, mainly belonging to culex tritaeniorhynchus, culex vishnui and culex pseudovishnui group.

The disease gets its name as the virus was first detected in Japan.

The ministry document said that seven districts in Gorakhpur and Basti division in Uttar Pradesh - Gorakhpur, Kushinagar, Deoria, Maharajganj, Sant Kabir Nagar, Basti and Siddarth Nagar - contribute over 90 percent of the Japanese encephalitis deaths in the state.

Official statistics said that last year 537 people lost their lives due to the disease in the state. The ministry also believes that it is children in the age bracket of one and 15 years who are facing the maximum difficulty due to the disease.

To curb the spread, the health ministry claims that it has vaccinated 83 percent of the children belonging to the high risk group in 21 of the 23 endemic districts of Uttar Pradesh.

One of the major problems facing Uttar Pradesh is wastage of vaccine due to its over-exposure to heat. This year alone, the state refused to use over a million doses of such vaccines due to the same problem.

Nov 24
New test finds chink in cancer's armour
Australian researchers, led by Dr Jeremy Henson at the Children's Medical Research Institute (CMRI) in Sydney, have developed a new quick and easy assay that detects the characteristic behaviour of certain cancer cells and could lead to the development of a test for most cancer types as well as new targeted chemotherapy drugs.

Almost all cancers use one of two mechanisms to continue multiplying indefinitely. Most utilise the enzyme telomerase, discovered by Elizabeth Blackburn and her colleagues, which enables the cells to prevent the ends of their chromosomes from 'unwinding' as they continue to divide.

The other technique is 'alternative lengthening of telomeres' (ALT), which is used by around 10 to 15 per cent of cancers, including some aggressive brain and bone cancers.

Until now, detecting ALT activity was a laborious and time consuming process - taking up to three months - but with the new assay, ALT activity can be screened for in only a few days.

The assay detects partially single-stranded telomeric (CCCTAA)n DNA circles - called C-circles - in the blood. These C-circles are ALT-specific, thus indicating the presence of a cancer that uses the ALT mechanism.

As there are already tests that detect the presence of telomerase, combining these with the assay for C-circles could lead to a single blood test that could rapidly screen for the presence of a majority of cancer types.

According to Henson, the assay could also aid in the discovery of ALT inhibitors, which could be used to develop drugs that kill the cancer without affecting normal cells.

"That's the longest shot, but I'm very optimistic," he said.

Finding ALT inhibitors has been a difficult process in the past, but with the new assay, the process can be sped up dramatically.

Nov 24
Launch of the AIDS Accountability Scorecard on Women
As World AIDS Day (1 December) approaches, AIDS Accountability International is releasing the first-ever global scorecard analysing country responses to the specific needs and vulnerabilities of women in the context of the AIDS epidemic: The AIDS Accountability Scorecard on Women 2009 - Are governments keeping their promises?

This independent assessment and rating is developed through a comprehensive consultative process with global health experts and civil society representatives from across the world, and evaluates data on women that all governments provide as part of the 2001 United Nations Declaration of Commitment on HIV/AIDS.

UNIFEM, represented by Ms. Nazneen Damji, Programme Specialist, Gender and HIV and AIDS, was on the development team for the creation of the scorecard.

Globally, HIV and AIDS is the leading cause of death and disease in women of reproductive age worldwide. Women and girls are particularly vulnerable to, and disproportionately affected by, HIV and AIDS in the global context. Lack of accountability for addressing women's needs hampers efforts to measure the impact of different approaches, reward effective efforts, adjust or stop ineffective ones and ensure good use of resources. Without better monitoring, the international community will be unable to assess whether the Millennium Development Goals and other internationally agreed targets are being met for a better response to women and girls in the context of HIV and AIDS.

Nov 24
Bacteria Key to Healthy Skin
Bacteria normally found on the skin's surface may play a key role in preventing inflammation and disease.

A new study shows that bacteria living on the skin's surface, including staphylococcal types that typically induce inflammation below the skin, actually prevent excessive inflammation after injury to the skin.

"It provides a molecular basis to understand the 'hygiene hypothesis' and has uncovered elements of the wound repair response that were previously unknown," researcher Richard Gallo, MD, PhD, professor of medicine and pediatrics at the University of California, San Diego, says in a news release. "This may help us devise new therapeutic approaches for inflammatory skin diseases."

The "hygiene hypothesis" emerged in the late 1980s to explain why allergies like hay fever and eczema were less common in children from large families who were exposed to more infectious agents. The theory suggests that a lack of early childhood exposure to infectious agents and microorganisms changes how the immune system reacts to bacterial threats.

In the study, published in Nature Medicine, researchers looked at the role of bacteria found on the surface of the skin in maintaining healthy skin using human and mice cell cultures in the lab.

The results showed activation of a Toll-like receptor 3 (TLR3) was necessary to stimulate normal inflammation after skin injury.

Researchers also found a previously unknown mechanism by which a product of staphylococci bacteria inhibits skin inflammation. The by-product, known as staphylococcal lipoteichoic acid (LTA), acts on the main type of cells found in the outer layer of the skin called keratinocytes via TLR3.

"Keratinocytes require TLR3 to mount a normal inflammatory response to injury, and this response is kept from becoming too aggressive by staphylococcal LTA," says Gallo. "To our knowledge, these findings show for the first time that the skin epithelium requires TLR3 for normal inflammation after wounding and that the microflora helps to modulate this response."

Researchers say the results emphasize the potential benefit of maintaining the balance of bacteria found in healthy skin and the potential negative consequences of altering this balance with the use of topical and systemic antibiotics.

Nov 21
Swine flu cases rise as chill sets in
If you think the worst of the influenza A H1N1 is now a thing of past, you are mistaken.

We are still in the midst of the first wave of the pandemic and experts warn that a second wave may be coming any time soon as winter sets in.

The World Health Organization (WHO) has warned that countries in the region - particularly India and Thailand - could see a second wave of the pandemic influenza this winter, which could be much more severe than the first attack.

"We have learnt from experience that influenza pandemics have a tendency to attack populations in periodic waves and that the second or third wave may cause more severe morbidity and mortality than the first," Dr Samlee Plianbangchang, the South-East Asian regional director of the WHO, warned countries in the region.

The influenza cases are already seeing a rising trend across India in the past two weeks. The number of laboratory- confirmed cases - which is a fraction of the actual number of cases in Delhi - have risen from 20 to 25 a day in the beginning of November to 65 to 70 cases a day now.

One of the reasons for this rise is attributed to the influx of cases referred from neighbouring states to Delhi, officials said. "There are no signs of a second wave as yet. Even in cold Scandinavian countries, there is no second wave till now. But the level of alertness continues," a health ministry official said.

"We are still in the middle of the first wave. The actual impact of the pandemic has not been fully determined," said Dr Jai P. Narain, director of communicable diseases at the WHO. "We must anticipate and prepare for the second wave, which may come soon." The experience of the first wave so far has given important insights into the nature of the virus and the pandemic. The first is communicability or transmissibility. It has now been established that the novel influenza virus is highly communicable and spreads fast. The second factor is virulence or the severity of the illness the virus causes.

"This is one area where we are still not very sure. So far, we have seen that the illness the virus causes is mild to moderate - one to two per cent patients need hospitalisation and fatalities are even less. But this may change in the future," said Narain. The third critical factor is the health systems' capacity to be able to respond.

Even if the current pattern of normally mild illness continues, the impact of the pandemic during the second and third waves could worsen as larger numbers of people could get infected and more severe symptoms might appear.

People who become severely ill will require intensive care, creating huge burden on health services, pressures could overwhelm ICUs and disrupt care for other diseases. That's why it is necessary to improve 'surge capacity' of hospitals.

The winter surge would be different from the situation in the ongoing first wave, needing a different strategy to tackle it. "The first wave was mostly imported, so airport vigilance was good enough. Now, the virus is circulating in the community and it would be much more difficult to control its spread," a health official said.

"Now that the infection is widespread within the country, the role of airport screening is not relevant anymore," said Narain.

Also, testing may not be necessary for everyone coming with the symptoms, as it puts a huge burden on the health system. Narain felt the decision whether a patient should be put on antiviral treatment, without testing, should be left to the judgment of the doctor.

While measures such as personal hygiene, hand washing and social distancing still need to be taken with vigour, the focus is now going to be on the availability of a vaccine to prevent H1N1 infection.

As far as treatment of those infected is concerned, Oseltamivir (sold under the brand name of Tamiflu) remains the first choice.

The WHO has revised its guidelines for the use of this drug.

The UN agency, in its latest communication to the health ministry, recommended that all those in 'at-risk' groups should be treated with antivirals as soon as possible if they have flu symptoms. This includes pregnant women, children under two years old, and people with underlying conditions such as respiratory problems.

Secondly, people who are not in the 'at-risk' group but who have persistent or rapidly worsening symptoms should also be treated with antivirals. These symptoms include difficulty in breathing and high fever lasting more than three days.

Thirdly, people who have developed pneumonia should be given both antivirals and antibiotics, as it has been observed that in many severe cases of H1N1 cases bacterial infection also develops.

Most developed countries have begun vaccination and want to immunise people before the second wave comes. Indian vaccine manufacturers have indicated they will have the vaccine ready for use by March or April 2010.

But enough doses of vaccine would not be available for everyone to be immunised nor does the country have resources to do that. So, India would have to prioritise which set of population it should be given to. Healthcare workers would be the first to be vaccinated. Then it could be given to population groups which are vulnerable - very young, very old and those with underlying conditions.

Till the indigenous vaccines become available, the WHO has promised to make available imported vaccine for frontline health workers in India. All foreignmanufactured vaccines will be allowed to be used in India only after they undergo necessary 'bridging' clinical trials in the country, the health ministry clarified.

Nov 20
New Brain Findings On Dyslexic Children
The vast majority of school-aged children can focus on the voice of a teacher amid the cacophony of the typical classroom thanks to a brain that automatically focuses on relevant, predictable and repeating auditory information, according to new research.

But for children with developmental dyslexia, the teacher's voice may get lost in the background noise of banging lockers, whispering children, playground screams and scraping chairs, the researchers say.

Recent scientific studies suggest that children with developmental dyslexia - a neurological disorder affecting reading and spelling skills in 5 to 10 percent of school aged children - have difficulties separating relevant auditory information from competing noise.

The research from Northwestern University's Auditory Neuroscience Laboratory not only confirms those findings but presents biological evidence that children who report problems hearing speech in noise also suffer from a measurable neural impairment that adversely affects their ability to make use of regularities in the sound environment.

"The ability to sharpen or fine-tune repeating elements is crucial to hearing speech in noise because it allows for superior 'tagging' of voice pitch, an important cue in picking out a particular voice within background noise," said Nina Kraus, Hugh Knowles Professor of Communication Sciences and Neurobiology and director of the Auditory Neuroscience Laboratory.

In the article "Context-dependent encoding in the human auditory brainstem relates to hearing speech-in-noise: Implications for developmental dyslexia," Kraus and co-investigators Bharath Chandrasekaran, Jane Hornickel, Erika Skoe and Trent Nicol demonstrate that the remarkable ability of the brain to tune into relevant aspects in the soundscape is carried out by an adaptive auditory system that continuously changes its activity based on the demands of context.

Good and poor readers were asked to watch a video while the speech sound "da" was presented to them through an earphone in two different sessions during which the brain's response to these sounds was continuously measured.

In the first session, "da" was repeated over and over and over again (in what the researchers call a repetitive context). In the second, "da" was presented randomly amid other speech sounds (in what the researchers call a variable context). In an additional session, the researchers performed behavioral tests in which the children were asked to repeat sentences that were presented to them amid increasing degrees of noise.

"Even though the children's attention was focused on a movie, the auditory system of the good readers 'tuned in' to the repeatedly presented speech sound context and sharpened the sound's encoding. In contrast, poor readers did not show an improvement in encoding with repetition," said Chandrasekaran, lead author of the study. "We also found that children who had an adaptive auditory system performed better on the behavioral tests that required them to perceive speech in noisy backgrounds."

The study suggests that in addition to conventional reading and spelling based interventions, poor readers who have difficulties processing information in noisy backgrounds could benefit from the employment of relatively simple strategies, such as placing the child in front of the teacher or using wireless technologies to enhance the sound of a teacher's voice for an individual student.

Interestingly, the researchers found that dyslexic children showed enhanced brain activity in the variable condition. This may enable dyslexic children to represent their sensory environment in a broader and arguably more creative manner, although at the cost of the ability to exclude irrelevant signals (e.g. noise).

"The study brings us closer to understanding sensory processing in children who experience difficulty excluding irrelevant noise. It provides an objective index that can help in the assessment of children with reading problems," Kraus says.

For nearly two decades, Kraus has been trying to determine why some children with good hearing have difficulties learning to read and spell while others do not. Early in her work, because the deficits she was exploring related to the complex processes of reading and writing, Kraus studied how the cortex -- the part of the brain responsible for thinking --encoded sounds. She and her colleagues now understand that problems associated with the encoding of sound also can occur in lower perceptual structures.