20th Oct 2014, 01:52 PM #1501
Re: Health Bulletin
Food pipe tissue grown from stem cells
Using a simple technique known as multiple combinations of cell populations, researchers have grown tissue of the oesophagus (food pipe).
The find could one day be applied to help children who have been born with missing portions of the organ, which carries food, liquids and saliva from the mouth to the stomach.
The tissue-engineered oesophagus formed on a relatively simple biodegradable scaffold after the researchers transplanted mouse and human organ-specific stem/progenitor cells into a murine model.
"This means that successful tissue engineering of the oesophagus is simpler than we previously thought," said principal investigator Tracy Grikscheit from the Saban Research Institute in the US.
Progenitor cells have the ability to differentiate into specific types of cell and can migrate to the tissue where they are needed.
The tissue-engineering technique discovered by the researchers required only a simple polymer to deliver the cells and multiple cellular groupings show the ability to generate a replacement organ with all cell layers and functions.
"We found that multiple combinations of cell populations allowed subsequent formation of engineered tissue," Grikscheit added.
"We have demonstrated that a simple and versatile, biodegradable polymer is sufficient for the growth of tissue-engineered oesophagus from human cells," Grikscheit said.
The process might also be used in patients who have had oesophageal cancer or otherwise damaged tissue, after having accidentally swallowed a caustic substance.
The study appeared online in the journal Tissue Engineering Part A.
20th Oct 2014, 01:53 PM #1502
Re: Health Bulletin
Enterovirus infection may up diabetes risk
Children who have had enterovirus infection are around 50 per cent more likely to develop type 1 diabetes, a new study has warned.
Enteroviruses are a group of viruses that include the polioviruses and can cause a range of symptoms from mild cold-like symptoms, to illnesses with fever and rashes to neurologic problems.
The study by Dr Tsai Chung-Li, China Medical University, Taiwan, and colleagues investigated the link between enterovirus (EV) infection and subsequent type 1 diabetes.
They used nationwide population-based data from Taiwan's national health insurance system and looked at type 1 diabetes incidence in children aged up to 18 years with or without diagnosis of EV infection during 2000-2008.
"Type 1 diabetes is considered to be caused by complex interaction between genetic susceptibility, the immune system, and environmental factors," researchers said.
"Though the cue for genetic predisposition has been elucidated, evidence also points to involvement of enterovirus infection, including viruses such as poliovirus, Coxsackievirus A, Coxsackievirus B, and echovirus," they said.
Researchers found that overall incidence of type 1 diabetes was higher in the EV-infected children than in the non-EV infected group (5.73 vs 3.89 per 100,000 people per year, showing a 48 per cent increased incidence rate in EV-infected versus non-EV-infected children).
Hazard ratios of type 1 diabetes increased with age at diagnosis of EV infection, with a more than doubling of the risk of type 1 diabetes (2.18 times increased risk) for children aged over 10 years at entry.
No relationship of allergic rhinitis or bronchial asthma to type 1 diabetes was found.
The authors pointed out that despite countries such as Finland and Sweden having the highest incidence of type 1 diabetes worldwide, they are thought to have low background rates of enterovirus infection, suggesting that genetic factors are a large component of the high type 1 diabetes rates in those countries.
"Regions such as Africa, Asia, South America have a low but increasing incidence of type 1 diabetes and high prevalence of enterovirus infection; environmental factors like enterovirus infection may play a vital role in increasing incidence in these regions," researchers said.
"Taiwan has relatively low type 1 diabetes incidence; we believe that the marked escalation of the said incidence in recent decades can be largely attributed to the highly endemic spread of enterovirus infection in Taiwanese children, given that there has been little gene flow and genetic drift in such a short period," they added.
The study was published in Diabetologia (the journal of the European Association for the Study of Diabetes).
20th Oct 2014, 01:53 PM #1503
Re: Health Bulletin
Birth season affects your mood in later life
People born in spring and summer may be great optimists and those born in autumn are less likely to be depressed than winter-borns, a new study suggests.
Birth season has a significant impact on your risk of developing mood disorders, scientists have found.
People born at certain times of year may have a greater chance of developing certain types of affective temperaments, which in turn can lead to mood disorders (affective disorders).
Researchers from Budapest, Hungary, found that birth season is linked with temperament.
"Biochemical studies have shown that the season in which you are born has an influence on certain monoamine neurotransmitters, such as dopamine and serotonin, which is detectable even in adult life," said Assistant Professor Xenia Gonda, lead researcher of the study.
"This led us to believe that birth season may have a longer-lasting effect. Our work looked at over 400 subjects and matched their birth season to personality types in later life.
"Basically, it seems that when you are born may increase or decrease your chance of developing certain mood disorders," Gonda added.
"We can't yet say anything about the mechanisms involved. What we are now looking at is to see if there are genetic markers which are related to season of birth and mood disorder," Gonda said.
The group found that cyclothymic temperament (characterised by rapid, frequent swings between sad and cheerful moods), is significantly higher in those born in the summer, in comparison with those born in the winter.
Hyperthymic temperament - a tendency to be excessively positive - was significantly higher in those born in spring and summer.
Those born in the winter were significantly less prone to irritable temperament than those born at other times of the year.
Those born in autumn show a significantly lower tendency to depressive temperament than those born in winter.
The study will be presented at the European College of Neuropsychopharmacology Congress here.
20th Oct 2014, 02:15 PM #1504
Re: Health Bulletin
75% of young adults exhibit signs of Osteoporosis: Study
Osteoporosis is often considered to be a condition that develops in the elderly. However, a study by Madras Medical College (MMC) shows that even young adults are at risk of developing the disease.
The hospital's department of rheumatology screened 1,172 people of the 20-40 age group, with around 80% being women, for bone density. It found that close to 75% either had osteoporosis or osteopenia, an early stage of the disease.
"We conducted this study mainly because there is a lack of awareness on osteoporosis and it is associated only with elderly people. The problem with osteoporosis is that people seek treatment only after developing complications," said Dr S Rajeswari, professor and HoD, department of rheumatology, MMC and Rajiv Gandhi Government General Hospital.
The focus of medical experts has primarily been on osteoporosis among the elderly and in women, who have a significant risk of developing the disease in the perimenopausal or postmenopausal period, she said.
Doctors say people achieve peak bone mass between the ages of 20 and 30 — a phase during which it is critical to focus on building bone strength, although one may start the process earlier, during puberty or adolescence.
The study carried out mass ultrasound screening of the heels of subjects, which provides results in the form of a 'T-score'. According to World Health Organisation criteria, the T-score of a normal individual is between 0 and -1. A person with osteopenia has a T-score between -1 and -2.5 and a person with osteporosis between -2.5 and -4.
Of the 75% with lower than normal bone density, more than half were osteopenic or had a high risk of developing osteoporosis, doctors said.
Various factors lead to osteoporosis bones including vitamin D3 or calcium deficiency, lack of protein intake particularly in childhood and adolescence, smoking, alcohol intake and a sedentary lifestyle. People with rheumatological disorders like rheumatoid arthritis and systemic lupus erythematosus are also at higher risk of developing osteoporosis.
20th Oct 2014, 04:53 PM #1505
Re: Health Bulletin
Human intestines grown inside mice for the first time
Human intestines have been grown inside mice for the first time ever giving hope of organs being grown as spare parts for repairing diseases tissues through transplants.
The intestine grew from a single stem cell to the size of a fingertip and was able to carry out many of the functions associated with digesting and absorbing food.
Researchers have successfully transplanted "organoids" of functioning human intestinal tissue grown from stem cells in a lab dish into mice - creating an unprecedented model for studying diseases of the intestine.
Scientists from Cincinnati Children's Hospital Medical Centre said that, through additional translational research the findings could eventually lead to bioengineering personalized human intestinal tissue to treat gastrointestinal diseases.
"These studies support the concept that patient-specific cells can be used to grow intestine," said Michael Helmrath, lead investigator and surgical director of the Intestinal Rehabilitation Program at Cincinnati Children's. "This provides a new way to study the many diseases and conditions that can cause intestinal failure, from genetic disorders appearing at birth to conditions that strike later in life, such as cancer and Crohn's disease. These studies also advance the longer-term goal of growing tissues that can replace damaged human intestine".
The scientists used induced pluripotent stem cells (iPSCs) - which can become any tissue type in the body - to generate the intestinal organoids. The team converted adult cells drawn from skin and blood samples into blank iPSCs and then placed the stem cells into a specific molecular cocktail so they would form intestinal organoids.
The human organoids were then engrafted into the capsule of the kidney of a mouse, providing a necessary blood supply that allowed the organoid cells to grow into fully mature human intestinal tissue.
The researchers noted that this step represents a major sign of progress for a line of regenerative medicine that scientists worldwide have been working for several years to develop.
Mice used in the study were genetically engineered so their immune systems would accept the introduction of human tissues. The grafting procedure required delicate surgery at a microscopic level, according to researchers. But once attached to a mouse's kidney, the study found that the cells grow and multiply on their own. Each mouse in the study produced significant amounts of fully functional, fully human intestine.
"The mucosal lining contains all the differentiated cells and continuously renews itself by proliferation of intestinal stem cells. In addition, the mucosa develops both absorptive and digestive ability that was not evident in the culture dish," Helmrath said. "Importantly, the muscle layers of the intestine also develop".
The new findings eventually could be good news for people born with genetic defects affecting their digestive systems or people who have lost intestinal function from cancer, as well as Crohn's disease and other related inflammatory bowel diseases (IBD).
One of the advantages of using tissue generated from iPSCs is that the treatment process would involve the patient's own tissue, thus eliminating the risk and expense of life-long medications to prevent transplant rejection.
Lab-grown organoids have the potential to replace much of the animal testing stage by allowing early drug research to occur directly upon human tissue. Going straight to human tissue testing could shave years off the drug development process, researchers said.
21st Oct 2014, 11:28 AM #1506
Re: Health Bulletin
Esophageal TB can mimic cancer: Doctors
Tuberculosis infection commonly affects the lungs. But do you know it can affect your food pipe?
A very rare disorder, esophageal tuberculosis (ET) can mimic cancer and might actually not show up in biopsy.
Dr SM Chandramohan, HOD, Surgical Gastroenterology, said they have seen only 31 cases in the last 17 years at the Rajiv Gandhi Government General hospital. These patients were suffering from symptoms like difficulty in swallowing, sleeplessness, loss of weight and other systematic manifestations.
"Patients can either come with tumors in their food pipe or extrinsic compression of the esophagus by the lymph nodes of trachea. While the first type can be diagnosed with an endoscopy, the second type can be confirmed with a CT scan," the surgeon said. Treatment depends on the stage of the disorder.
The 31 cases of ET was a part of 14 papers that a team of six post-graduates from the department of surgical gastroenterology, presented at the 14th World Congress of the International Society of Diseases of Esophagus.
21st Oct 2014, 11:28 AM #1507
Re: Health Bulletin
Viagra could be good for the heart: Study
A daily dose of anti-impotency drug Viagra which improves blood flow could provide a "safe" treatment for heart disease, a new study has claimed.
The study shows that long-term daily treatment of Viagra can provide protection for the heart at different stages of heart disease, with few side effects.
Phosphodiesterase-5 inhibitor (PDE5i) is the main ingredient in Viagra and other drugs commonly used to treat erectile dysfunction. The inhibitor blocks the enzyme PDE5, which prevents relaxation of smooth muscle tissue.
The presence of PDE5 in the heart has led to previous research on whether the inhibitor could treat non-urological conditions.
But despite some promising results, the studies were largely based on animals and the cardioprotective effects of PDE5i remained unclear.
Scientists from the Sapienza University of Rome carried out a meta-analysis of randomised controlled trials by searching for articles published between January 2004 and May 2014 to test the effectiveness of PDE5i in providing cardiac protection, and to find out whether it was well-tolerated and safe.
They identified 24 suitable trials for analysis from four research databases.
The trials involved 1622 patients from mixed populations who were treated with PDE5i or a placebo.
For the first time, the scientists conducted a parallel analysis of the effects of the inhibitor on the size and shape of the heart and its performance.
The analysis shows that PDE5i prevented the heart increasing in size and changing shape in patients suffering from left ventricular hypertrophy, a condition which causes thickening of the muscles in the left ventricle.
The inhibitor also improved heart performance in all patients with different heart conditions, with no negative effect on the patients' blood pressure.
"We found that the main ingredient in Viagra can be used as an effective, safe treatment for several patients with heart disease. Large clinical trials are now urgently needed to build on these encouraging findings," lead author of the study, Andrea Isidori said.
The study concludes that the inhibitor could be reasonably administered to men who suffer from heart muscle thickening and early-stage heart failure.
However, since most of the studies included in the meta-analysis were on men, the researchers suggest the next step should be a larger trial on sex-specific long-term responses.
The research was published in the journal BMC Medicine.
21st Oct 2014, 06:37 PM #1508
Re: Health Bulletin
Paralysed man walks again after historic spinal cord treatment by British doctors
Millions of paralysis sufferers are today offered the possibility of a cure for the first time after a new technique pioneered by British doctors allowed a man with a severed spinal cord to recover the ability to walk.
A revolutionary implant of regenerative cells has knitted back together the spinal cord of a wheelchair-bound firefighter paralysed from the chest down in a knife attack, restoring sensation and muscle control to his legs.
The astonishing breakthrough by an Anglo-Polish medical team is the first ever instance where a complete spinal paralysis has been reversed and represents the potential conquering of one of the greatest challenges in medical science. If validated, it offers hope of a life-changing therapy to the 2.5m people paralysed by spinal injury in Britain and across the world.
The technique, developed by researchers at University College London and put into practice by surgeons in the Polish city of Wroclaw, uses specialist human cells which repair damage to nasal nerves to enable spinal nerve fibres to re-grow and bridge a severed cord.
In the first procedure of its kind anywhere in the world, doctors implanted harvested cells - known as olfactory ensheathing cells (OECs) - into an 8mm gap in the spinal cord of Darek Fidyka, a Bulgarian who was confined to a wheelchair in 2010 after an attacker stabbed him in the back, slicing cleanly through his spine. His doctors had given him a less than one per cent chance of even the slightest recovery.
But doctors report today that the OEC implants on the two "stumps" of the cord slowly restored the nerve fibre connections between both sides of the injury, returning feeling and then movement to Darek's legs. Some ten months after the surgery, the 40-year-old former part-time firefighter was able to walk with the aid of braces and a walking frame. He is now able to drive and live more independently.
Professor Geoffrey Raisman, the head of UCL's Institute of Neurology who conducted the groundbreaking research into OECs, told The Independent: "I believe this is the first time that a patient has been able to regenerate severed long spinal nerve fibres across an injury and resume movement and feeling.
"I believe we have now opened the door to a treatment of spinal cord injury which will get patients out of wheelchairs. Our goal is to develop this first procedure to a point where it can be rolled out as a worldwide general approach."
He added: "We believe that this procedure is the breakthrough which, as it is further developed, will result in a historic change in the currently hopeless outlook for people disabled by spinal cord injury."
The London team and their collaborators at Wroclaw Medical University now need to raise about £10m to fund surgery in Poland for a further group of around ten patients to test and refine the implant technique over the next five years. Researchers are also exploring the possibility of bringing the technique to a British specialist unit. A person in Britain suffers a serious spinal injury once every eight minutes.
Much of the OEC research and rehabilitation therapy for Darek funded by a British charity, the Nicholls Spinal Injury Foundation (nsif), set up by professional chef David Nicholls after his teenage son, Dan, suffered a catastrophic neck injury while on a gap year in Australia in 2003.
Mr Nicholls said: "I promised Dan that I would not give up until a cure had been found. This news brings us closer than I could have imagined - it is an incredibly important first step."
The discovery by Prof Raisman and his UCL team that OECs held in the olfactory bulb - the part of the brain that processes smell - could facilitate the connection of regenerated nerves elsewhere in the body opened the door to work by Polish neurosurgeon Dr Pawel Tabakow, who specialises in spinal injuries.
Working alongside the British researchers, Dr Tabakow developed the technique to implant cultured OECs harvested from a patient's own olfactory bulb - and another type of nasal cell known as a fibroblast - on the stumps of a severed spinal cord. A scaffolding of nerve tissue was taken from the ankle to join the two ends of the cord to encourage bridging by the cells.
Darek, who underwent the surgery in 2012, had previously shown no signs of improvement since he was attacked in Poland two years earlier and been told his chances of recovering any sensation or movement from the chest down were negligible. On the international scale of grading spinal injury, he had been given "A" - the most severe classification with a complete loss of motor and sensory control.
The first signs that the technique was reaping rewards came six months later when Darek reported pain from a small pressure sore on his right hip - the first time he had felt sensation in his lower body since his attack.
Around the same time he began to feel tension being applied to his leg muscles during his post-operative physiotherapy and the impossible dream of so many paralysis sufferers - the recovery of sensation and movement - began to seem real.
Within 19 months of the operation, Darek was able to tell the direction of movement of his feet in tests with up to 85 per cent accuracy and could discriminate between the movement of his toes and his whole foot.
Recounting the moment he found he could once more feel his lower body, Darek told a BBC Panorama documentary due to be screened tonight: "When it starts coming back, you feel as if you start living your life again, as if you are born again."
The results of the procedure are reported today in the specialist medical journal, Cell Transplantation.
Both the medical teams and independent experts underlined that the new technique has so far only been applied to a single patient and its near-miraculous effects need to be repeated with a larger group. They added that the mechanism by which the OECs repair nerve connections must also be better understood.
Professor John Sladek, a cell transplantation expert at the University of Colorado, said: "Determination of the precise mechanisms of action, repetition in more patients and more long-term follow up are all necessary to help validate whether this promising procedure is of clinical relevance."
But for people like David Nicholls, the sight of Darek walking across a bridge at his Polish clinic is grounds for optimism where for many decades there has been none.
He said: "This information is being made available to researchers around the world so that together we can fight to finally find a cure for this condition which robs people of their lives."
22nd Oct 2014, 12:02 PM #1509
Re: Health Bulletin
Road accident cases: Good days ahead for Good Samaritans
In a move that will protect 'Good Samaritans' and encourage bystanders to rush road accident victims to the nearest hospital or inform the police, a Supreme Court appointed committee has recommended that such people should not be subjected to civil and criminal liability. Moreover, they should not be forced to disclose their identity and should not be called to appear for court hearings.
The recommendations by K Skandan Committee to the Supreme Court also mentions that any doctor refusing to attend or treat a road accident victim must face disciplinary action as per the norms laid down under the Medical Council of India (MCI) guidelines. The panel has suggested that all hospitals must admit such victims and the person accompanying the injured should not be detained by the hospital authority and authorities should not ask them for registration. There can be exception only in case the accompanying person is a family member of the victim.
According to the report, to ensure that all hospitals including private ones comply, the health ministry will issue guidelines which will have to be implemented within two months. If hospitals fail to do so, their licences can be revoked.
Moreover, there is a suggestion that hospitals should make public the charter on providing such services and if a good samaritan asks for an acknowledgement of his service then hospitals will provide such document or receipts.
Government sources said that both the road transport ministry and law ministry have accepted the report thereby paving the way for the country to get the first set of guidelines to protect good samaritans. The Supreme Court will hold a hearing on this next week and in all probability it may lay down the guidelines.
The Skandan committee has also recommended that in certain cases where the good samaritans are needed as witness there should be a system of video conferencing rather than calling such people to appear in the court in person.
It has also spelt out clearly that disciplinary actions should be initiated against police officers if there are complaints by good samaritans that they are being harassed or intimidated.
Nevertheless, the SC-appointed panel has also dealt in details with the infrastructure and other facilities that the governments should provide for quick transport of crash victims and for their proper treatment. While it has pitched for highway police across the country to man both national and state highways, it has recommended creating a corpus of Rs 1000 crore to take care of crash victims in hospitals.
"Doctors point out that at least 50% of the fatalities can be averted if victims are admitted to a hospital within the first one hour," a 201 report of the Law Commission report had highlighted.
Annually 1.37 lakh people die on our roads and the number of injured is
22nd Oct 2014, 04:49 PM #1510
Re: Health Bulletin
Injectable polio vaccine more effective than oral one: Experts
The Injectable Polio Vaccine (IPV) is more effective than the oral one, experts said here on Tuesday.
They emphasised that though the IPV was expensive, it carries the inactive forms of all three strains - Type 1, 2 and 3 - of the polio virus, with no risk of virulence.
But the oral polio vaccine (OPV) contains live but weakened form of virus which can give rise to occasional cases of polio.
"IPV is much more effective than OPV in a country like India. Had we adopted IPV earlier, we could have banished polio years ago," T Jacob John, chairman of the Child Health Foundation, said at the Ranbaxy Science Foundation's 32nd Round Table Conference on "Lessons from the Success of Polio Elimination" here.
Jacob said that though India has successfully combated the menace of polio using oral vaccines, it has to be kept in mind that only the wild polio viruses have been eliminated, while the vaccine-derived polio viruses still remain a threat.
According to the health ministry, IPV will be introduced in India through the universal immunization programme by 2015.
The vaccine will be linked with the global endgame strategy for polio which aims to eradicate the disease by 2018.
N.K. Ganguly, former director general of the Indian Council of Medical Research, said: "For a successful rollout of IPV in the country, the government needs to build capacity and ensure sufficient stocks and logistics. The availability of the vaccine would be a critical factor.
"We also need to build advocacy among the people and have trained manpower ready from the primary immunization field to administer the injections."
The experts also warned against the threat of virus import from Pakistan where the number of polio cases has already crossed 200 this year.
"The threat of virus importation from Pakistan is very real. Though it is now mandatory for everyone from the neighbouring country to take an additional dose of polio vaccine before entering India, measures like IPV can only reduce the risk," Ganguly said.
"It is necessary for India to keep 100 percent immunity status against polio until Pakistan gets polio free. Till that happens, we have to act as if we continue to have polio in our country and fight against it," he added.