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  1. #1661
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    Re: Health Bulletin

    Now, noninvasive MRI approach that can detect Alzheimer's disease early

    Researchers have recently developed a new non-invasive MRI method that can help detect Alzheimer's disease in its early stages.

    The team of Northwestern University scientists and engineers has developed this approach that can detect the disease at the earliest stages of the disease, well before typical Alzheimer's symptoms appear.

    Led by neuroscientist William L. Klein and materials scientist Vinayak P. Dravid, the research team developed an MRI (magnetic resonance imaging) probe that pairs a magnetic nanostructure (MNS) with an antibody that seeks out the amyloid beta brain toxins responsible for onset of the disease. The accumulated toxins, because of the associated magnetic nanostructures, show up as dark areas in MRI scans of the brain.

    Neuroscientist William L. Klein said that the ability to detect amyloid beta oligomers, was important for two reasons: amyloid beta oligomers are the toxins that damage neurons, and the oligomers are the first sign of trouble in the disease process, appearing before any other pathology.

    This ability to detect the molecular toxins might one day enable scientists to both spot trouble early and better design drugs or therapies to combat and monitor the disease.

    And, while not the focus of the study, early evidence suggested that the MRI probe improves memory, too, by binding to the toxins to render them "handcuffed" to do further damage.

    The research is published in the journal Nature Nanotechnology.


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  2. #1662
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    Re: Health Bulletin

    Risk of dengue increases due to climate change, city growth: Research

    Large parts of Europe, West and Central Africa, and South America face the threat of outbreaks of the deadly dengue virus due to climate change and urbanisation, according to the first-ever maps of dengue vulnerability published on Tuesday.

    Research by the United Nations University found dengue fever, that is transmitted by the bite of female mosquitoes and causes severe pain, is on the move with the maps pinpointing vulnerable areas as a tool to help prevent outbreaks.

    "Changes to climate could result in increased exposure and pose a serious threat to areas that do not currently experience endemic dengue," the report said.

    The researchers said as the planet warms, dengue could spread to large parts of Europe and mountainous regions of South America which are too cold currently to sustain mosquito populations year-round.

    The disease is also predicted to spread in Central and West Africa which have poor water and sanitation services and insufficient healthcare coverage.

    The new maps illustrate the expansion and contraction of dengue vulnerability throughout the year, revealing hotspots and showing where the virus could become a danger so countries can set up surveillance.

    "We`ve seen from Ebola that in this global world that we`re living in that infectious diseases can travel around," Corinne Schuster-Wallace, senior researcher at the UN University, told the Thomson Reuters Foundation in a phone interview from Canada.

    "The conditions for these diseases are dynamic over time and given that we`re changing our social and environmental dynamics, the global distribution of these infectious diseases like dengue is going to change."

    Although the maps are not designed to predict outbreaks, she said if the mosquitoes and the virus arrived in vulnerable areas, dengue would become endemic there.

    There is no vaccine for dengue, which kills an estimated 20,000 people each year and infects up to 100 million, according to the World Health Organisation (WHO).

    Some experts, however, say the number of people infected each year could be more than the three times the WHO estimate.

    The current approach to curbing the dengue is fumigation of sites where mosquitoes carrying the disease breed.


  3. #1663
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    Re: Health Bulletin

    Smartphone touchscreen use leads to greater brain activity

    Your smartphone touchscreen can actually change the way your thumb and brain work together, a new study has found.

    More touchscreen use in the recent past translates directly into greater brain activity when the thumbs and other fingertips are touched, researchers found.

    "I was really surprised by the scale of the changes introduced by the use of smartphones," said Arko Ghosh of the University of Zurich and ETH Zurich in Switzerland.

    "I was also struck by how much of the inter-individual variations in the fingertip-associated brain signals could be simply explained by evaluating the smartphone logs," Ghosh said. Ghosh and his colleagues realised that smartphones could be a grand opportunity to explore the everyday plasticity of the human brain.

    Not only are people suddenly using their fingertips, and especially their thumbs, in a new way, but many of us are also doing it a lot, day after day, researchers said. The phones are also keeping track of our digital histories to provide a readymade source of data on those behaviours.

    To link digital footprints to brain activity in the new study, Ghosh and his team used electroencephalography (EEG) to record the brain response to mechanical touch on the thumb, index, and middle fingertips of touchscreen phone users in comparison to people who still haven't given up their old-school mobile phones.

    The researchers found that the electrical activity in the brains of smartphone users was enhanced when all three fingertips were touched.

    In fact, the amount of activity in the cortex of the brain associated with the thumb and index fingertips was directly proportional to the intensity of phone use.

    The thumb tip was even sensitive to day-to-day fluctuations: the shorter the time elapsed from an episode of intense phone use, the researchers said, the larger was the cortical potential associated with it. The results suggest that repetitive movements over the smooth touchscreen surface reshape sensory processing from the hand, with daily updates in the brain's representation of the fingertips, researchers said. "We propose that cortical sensory processing in the contemporary brain is continuously shaped by personal digital technology," Ghosh and his colleagues said.

    The study is published in the Cell Press journal Current Biology.


  4. #1664
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    Re: Health Bulletin

    Whole-genome sequencing can identify cancer-linked mutations

    Scientists have found that whole-genome sequencing can be used to identify patients' risk for hereditary cancer.

    In a first of its kind study, researchers at University of Texas Southwestern Medical Center used whole-genome sequencing to evaluate a series of 258 cancer patients' genomes to improve the ability to diagnose cancer-predisposing mutations.

    "Whole-genome sequencing is a new genetic tool that can determine more of a person's DNA sequence than ever before," said Dr Theodora Ross, Professor of Internal Medicine and Director of UT Southwestern's Cancer Genetics Programme.

    "Our results show that nearly 90 per cent of clinically identified mutations were confidently detected and additional cancer gene mutations were discovered, which together with the decreasing costs associated with whole-genome sequencing means that this method will improve patient care, as well as lead to discovery of new cancer genes," Ross said.

    About 5 to 10 per cent of all cancers are caused by known inherited gene mutations. These mutations are passed down from generation to generation.

    Mutations in the BRCA1 and BRCA2 genes are the most common cause of hereditary breast cancer. BRCA gene mutations are best known for their breast cancer risk, but they also cause increased risk for ovarian, prostate, pancreatic, and other cancers.

    In addition, there are many different genes, including ATM, CDH1, CHEK2, PALB2, PTEN, and TP53, that are associated with an increased risk for breast cancer, and researchers are continually discovering additional genes that may affect cancer predisposition.

    In the study, researchers developed new methods to analyse the large amount of data generated by whole-genome sequencing.

    Ross' team devised a method to compare the group of patients with BRCA1 or BRCA2 mutations to a group of patients without BRCA mutations.

    All expected BRCA1 and BRCA2 mutations were detected in the BRCA group, with at least 88.6 per cent of mutations confidently detected. In contrast, different cancer gene mutations were found in the cohort without BRCA mutations.

    "The results demonstrate that whole-genome sequencing can detect new cancer gene mutations in non-BRCA 'mystery' patients, demonstrating the added value whole-genome sequencing brings to the future cancer clinic," Ross said.

    "Mystery patients are those who have a strong family history for cancer but after standard genetic testing, no genetic diagnoses are made.

    "In our study, sequencing allowed us to discover novel candidate cancer gene mutations in mystery patients," said Ross.

    The study is published in the journal EBioMedicine.


  5. #1665
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    Re: Health Bulletin

    Now, infertile couples may have kids from IVF

    A new research has demonstrated that infertile couples who cannot produce their own sex cells may finally be able to have children through IVF after scientists achieved a key breakthrough in making sperm and eggs from skin cells.

    Researchers have converted human skin cells in a laboratory into the "primordial germ cells" normally found within the testes and ovaries, which develop into mature sperm and eggs, the Independent reported.

    Professor Azim Surani of the University of Cambridge said that the development could also lead to a better understanding of the "epigenetic" changes within human cells that contribute to ageing and cancer because of the insights it will give scientists about how adult human skin cells can be reprogrammed into sperm and eggs.

    Surani continued that this was the first step in demonstrating that they could make primordial germ cells without putting them into patients to verify they were genuine.

    The development could also lead to a better understanding of the "epigenetic" changes within human cells that contribute to ageing and cancer and the development could also lead to a better understanding of the "epigenetic" changes within human cells that contribute to ageing and cancer.


  6. #1666
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    Re: Health Bulletin

    How lung cancer can be stopped from spreading

    To break loose and spread around the body, lung cancer cells first chop of the protein ties that bind them to other cells, new research shows, adding that targeting this flaw could help stop lung cancer from spreading.

    “This research shows for the first time how lung cancer cells sever ties with their neighbours and start to spread around the body, by hijacking the cells' recycling process and sending it into overdrive,” said lead researcher Angeliki Malliri from Cancer Research UK Manchester Institute at University of Manchester.

    Ties which bind cells together - controlled by a protein called TIAM1 - are chopped up when cell maintenance work goes wrong, the findings showed.

    Healthy cells routinely scrap old cell parts so they can be broken down and used again. But this process spirals out of control in lung cancer cells, which scrap too many TIAM1 ties.

    Targeting this recycling process could stop lung cancer from spreading by keeping the cells stuck firmly together.

    "Early-stage research like this is essential to find treatments which could one day block cancer spread - which would be a game changer,” Nell Barrie from Cancer Research UK said.

    The study was published in the journal Cell Reports.


  7. #1667
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    Re: Health Bulletin

    Hospitals, nursing homes get new code of ethics

    A new code of ethics will now govern hospitals, nursing homes and other similar medical establishments, prohibiting any malpractices such as earning cuts, commissions, inflating patients' bills and accepting freebies. The Indian Medical Association (IMA) has recently issued the broad guidelines for healthcare providers and asked them to put it on display.

    "IMA's Central Council has passed the declaration. We will bring out a detailed guideline explaining the code of ethics as declared. The detailed note will elaborate on what healthcare providers should do and not do," said Dr KK Aggarwal, who took over as IMA secretary general on Sunday.

    The detailed note on code of ethics, to be prepared within next three months, will also specify actions against hospitals if there is violation of the code, Dr Aggarwal said.

    The present declaration, passed by IMA, highlights that hospitals or other such establishments will not "accept expensive gifts, cash benefits or gratification from the drug and equipment suppliers, diagnostics centres or similar agencies". It also clearly states that unjustified admissions or billing to patients, giving cuts and commissions to anyone for soliciting patients, over-billing in claim cases or improper entries in insurance forms will be considered 'unethical or illegal' as is the case with sheltering any criminal from law and pre-natal sex determination.

    The idea is to prepare a basic guideline for regulation of hospitals and other such medical establishments, which currently remains completely unmonitored.

    The move comes in the wake of reports of hospitals engaging in unethical practices, mainly giving or accepting cuts or commissions and for unjustified billing among other things.

    Though, such code of ethics already exists for individual doctors, who are regulated by Medical Council of India, institutions housing most of these doctors remain outside the Council's purview. While the government recently brought in voluntary code of ethics for pharmaceutical companies, the Clinical Establishment Act planned for healthcare providers such as hospitals still remains in limbo due to reservations from various quarters.

    "It is important to have a coordinated regulation to cover the whole supply chain. While doctors and drug makers have code of ethics, not having the same for hospitals will puncture the system," Dr Aggarwal said.

    There are around 5000 hospitals registered with the Hospitals Board of India, a wing of IMA looking specifically into hospitals. Besides, IMA is also coordinating with other organisations such as Medical Council of India, Delhi Medical Council, NatHealth Network and Association of Healthcare Providers to implement the code of ethics in medical establishments.


  8. #1668
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    Re: Health Bulletin

    Taking notes kills your memory

    Most of us take notes be cause we think doing so will help us remember what we're learning. According to psychologists at Mount St. Vincent University in New York, our brains have a different view: "Hey, ferent view: "Hey, he's writing this down, so no need to warehouse this stuff.Better to make room for other stuff." Researchers call this phenomenon intentional forgetting.

    In experiments, subjects played the memory game Concentration, in which players memorize images on cards and try to identify them after the cards have been covered up. Half of the subjects was able to study the cards before they were covered; the other half was allowed to take notes. Then the researchers took away the notes and made them play . The note-takers did significantly worse than the group that knew they had to concentrate on the images and position of the cards.

    The researchers concluded that "participants adopted an intentional-forgetting strategy when using notes to store certain types of information." In other words, taking notes didn't improve memory; it made recall worse because the brain was forgetting as fast as its owner was writing.

    Next time a boss asks why you're not taking notes, explain that you want to make sure you remember. (On the other hand, if you completely space out, it's always useful to have notes to fall back on.)


  9. #1669
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    Re: Health Bulletin

    New worry: Resistance to 'last antibiotic' surfaces in India

    It is the beginning of the end. Hospitals in India are now recording cases of infections resistant to colistin, the last antibiotic available in the world, which was brought back from a 40-year exile in 2005 to treat increasing number of infections resistant to other high-end antibiotics.

    For now, colistin is the only cannon left in the medical armoury to treat bacterial infections, mainly those acquired in the hospital that no drug can treat. The number of cases resistant to colistin is still rare, but worrisome, say doctors.

    The first-ever evidence of pan-drug resistant cases has now been recorded by three Chennai-based doctors. Their paper: 'Emergence of pan-drug resistance amongst gram negative bacteria! The first case series from India', published in the latest issue of Journal of Microbiology and Infectious Diseases, maps 13 colistin-resistant cases recorded over 18 months. It concludes that pan-drug resistant infections, particularly those in the blood stream, have a higher mortality.

    Tertiary care hospitals across the country are recording cases of infections that even colistin can't treat. Colistin resistance has been detected at 4 to 5 % in Delhi hospitals. In Pune's state-run Sassoon General Hospital, of the 799 drug-resistant bacteria tested between January and July in 2014, 36 were found to be colistin resistant. Stray cases have been reported at Ruby Hall Clinic in Pune and doctors at Tata Memorial Hospital in Mumbai recall one case in the last three to four years.

    "Colistin resistance is still rare. It is carbapenem (the strongest class of antibiotic) resistance that is increasing across the world. Colistin is used to treat cases that are resistant even to carbapenem. It is an emerging problem. Doctors in Greece had published colistin-resistance data in 2006, and the US recorded it two years ago," said infectious diseases consultant Dr Abdul Ghafur, one of the authors of the paper on the 13 cases, and also the coordinator of Chennai Declaration that has laid out guidelines for hospitals and doctors on antibiotic use.

    Ramanan Laxminarayan, vice president for research and policy at the Public Health Foundation of India said the use of colistin itself is a concern. "It is not a preferred antibiotic. In Vietnam, it was used only in animals till a few years ago," he added.

    Such concerns notwithstanding, India has little choice but to use the drug, that was in exile since 1970 for its toxicity, to treat the rising resistance to carbapenem, a third-generation antibiotic used to treat cases resistant to lower drugs.

    Most hospitals are still wary of reporting colistin-resistance figures, but doctors now admit that it is time to acknowledge the problem so that corrective measures can be taken.

    Understanding colistin

    It became available for clinical use in the 1960s, but was replaced in the 1970s with other antibiotics owing to its toxicity

    However, with antibacterial resistance on the rise, colistin is increasingly being used to treat severe, multidrug-resistant gram-negative bacterial infections, particularly among intensive-care patients

    Colistin is used when all or almost all other drugs have failed and is often a patient's last hope for survival.

    Factors fuelling resistance

    Exposure to infections in hospitals and the practice among many doctors to prescribe strong antibiotics even for common flu is fuelling resistance to antibiotics.

    Quoting reports, Dr Prachee Sathe, head of critical care, Ruby Hall Clinic, said hospitalised patients acquire 11 to 83% of infections, and that 30% of total sepsis deaths are due to antibiotic resistance. Long hospital stay, use of in-dwelling catheter and overuse of antibiotics add to resistance, she added, pointing out that sepsis accounts for more than half of all hospital deaths.

    Dr J V Divatia, professor and head of department of anaesthesia, critical care and pain at Tata Memorial Hospital, Mumbai, said community-acquired infections, such as pneumonia, are still sensitive to antibiotics. "But the resistance is high in hospital-acquired infections. The resistance to carbapenem is 50 to 60%. In the case of acenotobacter (a hospital bug) seen in ICU patients, the resistance is 70 to 80%," he said.

    The only superior drug to carbapenem is colistin and medical journals refer to it as the 'last-line' therapeutic drug against multidrug-resistant gram-negative pathogens in the 21st century.

    But bacteria that people were once exposed to only in the hospital, are now being reported in the safe environs of homes. Dr Divatia mentioned resistant E coli found in stool samples of even people whose only exposure to the hospital had been that of a regular health check.

    Dr Sathe recalled a case of an otherwise healthy patient who came for pneumonia treatment and was put on the ventilator, but was detected with two bacteria - MRSA and klebsiella -infections that are usually reported after a long hospital stay.

    Treatment roadblock

    India drafted the antibiotic policy in 2011 and hospitals have only now started implementing it. Now, there are clear guidelines on the judicious use of antibiotics. While tertiary-care hospitals, at least the major ones in the country, have an infection control mechanism in place, on many occasions patients reach them after they have been exposed to infections and antibiotic overuse in smaller hospitals, point out experts.

    "The biggest problem we face is that patients come to us after visiting a general practitioner who would have started treatment with high-end antibiotics. So we have to first de-escalate the antibiotic dosage to identify which organism is growing and which is sensitive," said Dr Vishnu Reddy, former chairman of the infection control committee of Yashoda Hospitals in Hyderabad.

    A high-on-antibiotics treatment only derails quick response to a resilient infection, say doctors. Add to that the time it takes to zero down on the infection-causing bug. Much like the nail-biting diagnosis marathon of Dr House with his team, it is an excruciating wait to zero down on the infection-causing bug, almost three days, during which time doctors start what they call empirical treatment (particularly when the patient is critical), which includes administering a broad spectrum antibiotic to eliminate a range of bugs. However, it often ends up killing the sensitive bacteria, and pushes the growth of resistant ones.

    Dr Sathe said the overuse of antibiotics that too targeted at incorrect bacteria, only strengthen the resistant ones. There are molecular techniques coming up that can give reports within six to 24 hours, but it could well take time for them to hit the market.

    The way ahead for now is combination therapies that doctors are already using, and the hope for new research and a new antibiotic to be developed.

    Among those working on it is Hyderabad-based Vista Pharma. "We are focussed on developing novel antibiotics, novel drugs that work on any sort of resistant organism because the compounds have never been used on the bacteria before. We are in the pre-clinical, R&D phase to identify good, effective safe molecules for infections resistant to carbapenem and last-line antibiotics," said Radha Rangarajan, founder and CEO of Vitas. Till then, colistin is the only option with doctors.

    Why self-medication is a public health issue

    In the story of antibiotic resistance are bigger public health concerns that need immediate attention-self-medication with antibiotics for treating as routine infections as cough, cold and fever to over-the-counter availability of even high-end antibiotics to mixing antibiotics in poultry feed being some of them.

    Using antibiotics inappropriately, such as stopping dosage mid-course, also breeds resistance and so does the quality of the drug being consumed.

    Experts note antibiotic resistance is not just the hospital's responsibility. "It is each individual's responsibility and also that of the veterinary industry," says Dr Renu Bharadwaj, head of department of microbiology at B J Medical College in Pune.

    "The resistance to antibiotics is very low in Norway, Sweden and Finland because of their judicious use in the line of treatment and very good infection control practices," said Dr Suneetha Narreddy, infectious diseases consultant with Apollo Hospitals, Hyderabad. She also expresses concern about the promotion of generic drugs, with the same drug diversely priced between Rs 250 and Rs 3,000, but without any quality indicator.

    How to tackle resistance

    Antibiotics should be avoided to treat common ailments such as cough, cold and fever, unless advised by doctor

    Antibiotic dosage should not be stopped midway as it breeds resistance of infection-causing bacteria

    If the doctor suggests discharge from hospital, leave immediately. Longer stay only increases exposure to hospital infections

    For hospitals

    Hospitals should have a good infection control mechanism in place

    They should follow the antibiotic policy, which suggests judicious use of drugs

    Prescribing and dispensing the right antibiotic

    For veterinary industry

    Judicious use of antibiotics in animal feed

    Record antibiotic usage

    Better management and housing of animals to reduce infection possibility

    WHO recommends

    Policymakers can help tackle resistance by:

    Strengthening resistance tracking and laboratory capacity

    Regulating and promoting appropriate use of medicines

    Fostering innovation and research and development of new tools

    Promoting cooperation and information sharing among all stakeholders

    India's policy

    Observations:

    * A major factor responsible for this is the widespread use and availability of practically all anti-microbials over the counter for human as well as animal consumption

    * In India, antibiotics are used widely in food animals as growth promoters and to prevent and treat infection.

    Non-therapeutic usage of antibiotics has been especially common in poultry production. However, there is no regulatory provision regarding the use of antibiotics in livestock

    Suggestions:

    Establish intersectoral coordination committee with experts from various sectors. Develop regulations on usage of anti-microbials in poultry and other animals as well as the requisite labelling requirements in food.

    Promote appropriate use of antibiotics through various interventions to stop unnecessary prescribing and misuse of antibiotics


  10. #1670
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    Re: Health Bulletin

    Your birth year can influence obesity risk

    People born before 1942 are less likely to be affected by a variant to a gene linked to obesity risk than those who are born after 1942. The effect is stronger in those born in later decades, finds a fascinating research.

    The findings underscores the effect of broad environmental changes to increase in obesity in recent times.

    “We found that the correlation between the best known obesity-associated gene variant and body mass index increased significantly as the year of birth of participants increased," said lead author James Niels Rosenquist from Massachusetts General Hospital (MGH).

    The researchers used data gathered between 1971 and 2008, when participants ranged in age from 27 to 63.

    Looking at the relationships between participants' body mass index (BMI), as measured eight times during the study period, and the FTO gene variants they had inherited.

    The previously reported association between a specific FTO variant and BMI was seen, on average, only in participants born in later years.

    While there was no correlation between the obesity-risk variant and BMI for those born before 1942, in participants born after 1942 the correlation was twice as strong as reported in previous studies.

    Post-World War II factors such as increased reliance on technology rather than physical labour and the availability of high-calorie processed foods are likely contributors to the environmental effects of obesity, the authors noted.

    The study appeared in the journal PNAS Early Edition.


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