9th Feb 2014, 06:29 PM #791
Re: Health Bulletin
The miracle cure: Scientists turn human skin into stem cells
Human skin cells have been turned into stem cells which have the potential to develop into fully-formed embryos, simply by bathing them in weak citric acid for half an hour, a leading scientist has told The Independent on Sunday.
The demonstration that the technique, which was pioneered on mouse cells, also works on human skin cells raises the prospect of new treatments for incurable illnesses, from Parkinson's to heart disease, based on regenerating diseased organs in situ from a patient's own stem cells.
Although there is no intention to create human embryos from skin cells, scientists believe that it could, theoretically, be possible to do so given that entire mouse embryos have already been effectively created from the re-engineered blood cells of laboratory mice.
Creating the mouse embryos was the final proof the scientists needed to demonstrate that the stem cells were "pluripotent", and so capable of developing into any specialised tissue of an adult animal, including the "germ cells" that make sperm and eggs.
Pluripotent stem cells could usher in a new age of medicine based on regenerating diseased organs or tissues with injections of tissue material engineered from a patient's own skin or blood, which would pose few problems in terms of tissue rejection.
However, the technique also has the potential to be misused for cloning babies, although stem cell scientists believe there are formidable technical, legal and ethical obstacles that would make this effectively impossible.
A team of Japanese and American scientists converted human skin cells into stem cells using the same simple approach that had astonished scientists around the world last month when they announced that they had converted blood cells of mice into stem cells by bathing them in a weak solution of citric acid for 30 minutes.
The scientist who instigated the research programme more than a decade ago said that he now has overwhelming evidence that the same technique can be used to create embryonic-like stem cells from human skin cells.
Charles Vacanti, a tissue engineer at Brigham and Women's Hospital in Boston, Massachusetts, said that the same team of researchers has generated stem cells from human dermal fibroblasts — skin cells — which came from a commercial source of human tissues sold for research purposes.
"The process was very similar to the one we used on mouse cells, but we used human dermal fibroblasts that we purchased commercially," Dr Vacanti said. "I can confirm that stem cells were made when we treated these human cells. They do the same thing [as the mouse cells].
"They revert to stem cells, and we believe the stem cells are not a contamination in the sample that we were inadvertently sent by the company, but that they are being made, although we still have to do the final tests to prove this," he added.
"We have strong evidence that we have now made human stem cells by the same technique used on mouse cells and it suggests that there is probably a parallel process going on. I'm 98 per cent comfortable with the results so far."
Detailed genetic tests and further experiments will be needed to prove beyond any doubt that the cells are true stem cells, although Dr Vacanti emphasised that he will not be carrying out the same experiments on the human stem cells that led to the creation of mouse embryos from mouse stem cells.
"My interest is to demonstrate the biological process, to grow your own perfect embryonic stem cells in order to repair your own damaged tissues - but without making an embryo," Dr Vacanti said.
"In order to repair tissues you need embryonic stem cells, but the irony is that in order to show that you don't need an embryo you have to sometimes create an embryo - in mice at least."
Asked whether it would be possible in theory to follow on from the mouse research to show that skin cells could be turned into viable human embryos - effectively a clone of the donor of the skin samples — Dr Vacanti said: "This is an offshoot, an unintended consequence, so the answer is 'yes' .... This would be the natural conclusion, but I won't be the one that does it."
Robert Lanza, a stem cell expert at Advanced Cell Technology in Massachusetts, said that if the technique has been made to work on human cells as Dr Vacanti has described, then it could be a "paradigm changer" in terms of using stem cells for therapeutic purposes.
However, the development also raises serious questions about its possible unauthorised use for cloning babies,
"Because of the ease of the methodology, this research could have serious ethical ramifications," Dr Lanza said. "If the cells are truly totipotent [able to develop into any cell type], then this technology could be used to clone organisms ... and perhaps even humans."
9th Feb 2014, 06:31 PM #792
Re: Health Bulletin
Indian-origin doctor in US implants first leadless pacemaker inside patient's heart
An Indian-origin doctor in the US has implanted the first miniature-sized, leadless cardiac pacemaker directly inside a patient's heart without surgery.
The leads-free pacemaker is implanted directly inside the heart during a catheter-guided procedure through the groin via the femoral artery.
The device implanted by Vivek Reddy from The Mount Sinai Hospital, resembles a small metal silver tube, and is only a few centimetres in length, making it less than ten per cent the size of a traditional pacemaker.
The Nanostim device, made by St Jude Medical, is being tested for safety and efficacy in an international, multicentre clinical trial called LEADLESS II, which is planning to enroll 670 patients at 50 centres across the US, Canada, and Europe.
"This clinical research trial will be testing the latest innovative, non-surgical pacemaker option for patients experiencing a slowed heart beat," said Reddy, the study's co-investigator.
"This new-age, tiny pacemaker may ultimately be safer for patients because it doesn't have leads or have to be inserted under the skin of a patient's chest, like a traditional cardiac pacemaker," Reddy said.
Similar to other cardiac pacemakers, the Nanostim device treats a heart rate that is too slow called bradycardia.
It works by closely monitoring the heart's electrical rhythms and if the heart beat is too slow it provides electrical stimulation therapy to regulate it.
More than 4 million patients globally have a pacemaker, and 700,000 new patients receive one each year, researchers said.
The possible advantages of the leadless pacemaker include the elimination of a surgical pocket and no visible pacemaker device under a patient's chest skin, no incision scar on the chest, no connector wires or leads, and no restrictions on a patient's activities.
The device's benefits may also allow for less patient discomfort, infections, and device complications and dysfunction.
In addition, the free-standing, battery-operated pacemaker device is designed to be fully retrievable from the heart.
"The same cardiac pacing results for patients may be available with this smaller leads-free device with the added benefits of a non-surgical procedure and less complication risks," said Srinivas Dukkipati, who is the study's principal investigator.
10th Feb 2014, 01:40 PM #793
Re: Health Bulletin
Kids suffering brain stroke not rare: Study
Brain stroke in children is considered to be rare. But an ongoing study by a city hospital has revealed that it may not be that uncommon after all. Worse, many cases may be going undiagnosed or wrongly treated.
Around eight months ago, the Kokilaben Dhirubhai Ambani Hospital, Andheri, initiated a study to track patients under 18 coming for stroke treatment. To their surprise, they clocked 16 patients—an average of two a month. Annually, 1.5 million adult Indians suffer strokes, but the number of kid sufferers is unknown. The study found none of the patients got diagnosed or received correct treatment within the first four hours, considered 'golden' for best treatment outcome, of suffering a stroke. A few were admitted to nursing homes and tertiary-care hospitals, which did not perform correct diagnoses. Most children got the appropriate treatment after 12-72 hours were lost.
"Even in a city like Mumbai, awareness about stroke in children remains shockingly low. Paediatricians and physicians often misread the signs for something else and children lose out on correct, timely treatment," said Dr Pradnya Gadgil, paediatric neurologist at KDAH. She said the aim of the study is to evolve a treatment protocol, as currently it is extrapolated from adult stroke management.
"For Indian children suffering strokes, a unique reason is trauma or a minor injury caused by, say, a fall. It is common in children below three here and is rarely seen anywhere else in the world," said Dr Vrajesh Udani, paediatric neurologist at PD Hinduja Hospital, Mahim, which treats two or three stroke cases among children a month. Udani said the incidence of pediatric stroke in India may be slightly higher than in the West
Stroke occurs when blood supply to the brain is interrupted by a clot in an artery, or by the bursting of a blood vessel inside or outside the brain. Lack of oxygen (supplied by blood) even for a few seconds can disrupt the brain's functioning and permanently damage bodily movements the affected brain area controls.
The youngest child to get stroke was a one-year-old and the oldest was 17. The baby was diagnosed with an underlying cardiac condition, but the cause of stroke in the teen could not be established. In all, children have better chances of recovering from a stroke. The mortality rate among adult sufferers is 30%. "Even if mortality among child sufferers is low, morbidity (the number of people who have a disease in a particular population) can be significantly high," said paediatric neurologist Dr Shekhar Patil, who consults with Jupiter Hospital, Thane.
In the KDAH study, out of the 16 children, four (25%) went home with longstanding neurological deficits. Gadgil said two children had weakness in one side of the body and had difficulty with walking, while the others had facial drooping, loss of movement in hands and palms, and inability to perform motor tasks like buttoning a shirt. "These problems can be resolved with neuro rehabilitation. Children have brains like plastic, easy to mould."
City neurologists believe the scenario is getting better. "We are diagnosing the condition faster. Also, we have a better understanding of the reasons," said Dr Sangeeta Rawat, head of neurology, KEM Hospital, Parel. Artery problems, heart conditions, congential malfunction of blood vessels and infectious diseases like tuberculosis are primarily responsible for stroke in the paediatric age-group, she said.
Treatment remains the biggest point of contention as some of the most effective methods to treat stroke cannot be used on small children. "The methods include thrombolysis (bursting clot with medicine) and other invasive approaches. The world over, stroke management for children is still evolving," said Gadgil.
10th Feb 2014, 03:50 PM #794
Re: Health Bulletin
New guidelines to treat stroke risks among women
Women who have high blood pressure before pregnancy and women who have moderate blood pressure during pregnancy are at increased risk to stroke and should hence be given medications to control the condition. This is one of the many recommendations for women put up by the American Heart Association for the first time. AHA guidelines are followed by physicians across the world and are hence much awaited.
Women as against men were until recently not considered to be as much risk of stroke. But AHA's efforts show that this belief has now disappeared.
"If you are a woman, you share many of the same risk factors for stroke with men, but your risk is also influenced by hormones, reproductive health, pregnancy, childbirth and other sex-related factors," said Cheryl Bushnell, author of the new scientific statement published in the American Heart Association journal Stroke.
The guidelines say:
Women with a history of high blood pressure before pregnancy should be considered for low-dose aspirin and/or calcium supplement therapy to lower preeclampsia risks.
Women who have preeclampsia have twice the risk of stroke and a four-fold risk of high blood pressure later in life. Therefore, preeclampsia should be recognized as a risk factor well after pregnancy, and other risk factors such as smoking, high cholesterol, and obesity in these women should be treated early.
Pregnant women with moderately high blood pressure (150-159 mmHg/100-109 mmHg) may be considered for blood pressure medication, whereas expectant mothers with severe high blood pressure (160/110 mmHg or above) should be treated.
Women should be screened for high blood pressure before taking birth control pills because the combination raises stroke risks.
Women who have migraine headaches with aura should stop smoking to avoid higher stroke risks.
Women over age 75 should be screened for atrial fibrillation risks due to its link to higher stroke risk.
11th Feb 2014, 12:56 PM #795
Re: Health Bulletin
Dermatologists launch initiative to create awareness about topical steroid abuse
The Indian Society of Teledermatology (INSTED) and the Chennai Chapter of Indian Association of Dermatologists, Venereologists and Leprologists recently launched a 'Movement against Topical Steroid Abuse,' a social initiative to create awareness among the general public, patients, parents, physicians, pharmacists and paramedical personnel on the menace of steroid abuse.
Jayakar Thomas, president of INSTED, said topical steroids are used by dermatologists to treat a wide range of skin disorders. "The MATSA initiative is aimed at sensitizing people to prevent the misuse of the topical steroids and discuss the growing medical and social problem of topical steroid addiction," he said.
Speaking at the programme, Dr T S Selvavinayagam, joint director of health, said, "Topical steroid abuse for fairness of the skin is a grave concern. As health administrators, we have a duty to create awareness about the misuse and also to support such initiatives."
The doctor warned that topical steroids are to be used judiciously under the supervision of a dermatologist. "But with existing scenario where medicines are dispensed by pharmacies without a prescription, the misuse of topical steroid has grown into a menace to the society," he pointed out.
Scores of people in India and all over world misuse topical steroids ignorant of its adverse events and the permanent damage they themselves are causing to the skin, according Dr Selvavinayagam.
11th Feb 2014, 01:05 PM #796
Re: Health Bulletin
Women in 20s more vulnerable to ovarian cancer, finds study
About 31% of women in the 20-29 age group in Chennai are at a higher risk of ovarian cancer, a recent study has revealed. The two-year study by Lister Metropolis tested women across the country and found a large chunk tested positive for Cancer Antigen-125, a protein produced by some ovarian cancer cells and released in the blood stream.
Of the 3,487 women evaluated, 27% tested positive. Most women evaluated were between ages 20 and 89 years. The lab analyzed data from January 2012 to November 2013 from its facilities in Chennai and other cities like Bangalore, Delhi and Mumbai. While Delhi topped the list with 31% testing positive followed by Chennai with 27% testing positive, Bangalore had the lowest incidence with 24%.
Lister Metropolis vice-president (operations) Dr Anita Suryanarayanan said traditionally the risk of developing ovarian cancer increased as women grew old but data showing younger women in Chennai being at a higher risk was worrying. "When problems like endometriosis and polycystic ovary disorder (PCOD) are not treated on time, they can develop into malignant cysts, " she said. Young women are undergoing rapid changes in terms of lifestyle and diet, making them pre-disposed to ovarian cancer, she added.
Ovarian cancer is asymptomatic and has subtle signs like unusual loss of weight, appetite, irregular menstruation. "Since the symptoms are vague it could be mistaken as other disorders and when the diagnosis happens, it is too late," said Dr Suryanarayanan.
An elevated level of CA-125 does not necessarily mean a person is at risk of developing ovarian cancer, says gynaecologist Dr A R Shanti. "The levels of CA-125 can be elevated for various reasons, including TB, presence of fibroids, during menstruation, etc.," she said. It was important to analyze demographic details of the patient along with clinical findings about their hereditary conditions and diet.
11th Feb 2014, 01:12 PM #797
Re: Health Bulletin
TVs, cars, computers linked to obesity in poor nations
In low-income countries, people with cars, televisions and computers at home are far more likely to be obese than people with no such conveniences, researchers said on Monday.
Eating more, sitting still and missing out on exercise by driving are all likely reasons why people with these modern-day luxuries could be gaining weight and putting themselves at risk for diabetes, researchers said.
The findings in the Canadian Medical Journal suggest extra caution is needed to prevent health dangers in nations that are adopting a Western lifestyle.
"With increasing uptake of modern-day conveniences - TVs, cars, computers - low and middle income countries could see the same obesity and diabetes rates as in high income countries that are the result of too much sitting, less physical activity and increased consumption of calories," said lead author Scott Lear of Simon Fraser University.
"This can lead to potentially devastating societal health care consequences in these countries."
The same relationship did not exist in developed nations, suggesting the harmful effects of these devices on health are already reflected in the high obesity and diabetes rates.
The study included nearly 154,000 adults from 17 countries across the income spectrum, from the United States, Canada and Sweden to China, Iran, India, Bangladesh and Pakistan.
Televisions were the most common electronic device in developing countries -- 78 percent of households had one -- followed by 34 percent that owned a computer and 32 percent with a car.
Just four percent of people in low-income countries had all three, compared to 83 percent of people in high-income countries.
Those that did have electronics were fatter and less active than those that did not.
People with all three were almost a third less active, sat 20 percent more of the time and had a nine-centimeter (3.5 inches) increase in waist circumference, compared to those that owned none of the devices.
The obesity prevalence in developing countries rose from 3.4 percent among those that owned no devices to 14.5 percent for those that owned all three.
In Canada, about 25 percent of the population is obese and in the United States, about 35 percent of people are obese.
"Our findings emphasize the importance of limiting the amount of time spent using household devices, reducing sedentary behavior and encouraging physical activity in the prevention of obesity and diabetes," said the study.
11th Feb 2014, 01:15 PM #798
Re: Health Bulletin
Suffering from insomnia? Blame it on your phone
We've all been there. You wake up in the middle of the night and grab your smartphone to check the time — it's 3am — and see an alert. Before you know it, you fall down a rabbit hole of email and Twitter. Sleep? Forget it.
Well, I've found a $7 solution: an old-fashioned alarm clock. My smartphone has been banished from the bedroom.
Sure, you can flip your phone to quiet mode. But the draw to roam in the early hours is powerful. Sleep researchers say this isn't good for you. You might as well get up and drink a shot of espresso.
"It's a very slippery slope, once you've picked up your phone, to see what time it is, to checking your email, to lying awake with anxiety," said David M. Claman, director of the Sleep Disorders Center at the University of California San Francisco Medical Center. "If you wake up in the middle of the night and check your phone, you will inevitably get frustrated and worried by something you've seen, leading your body to tense up."
Then it's game over. You're tossing and turning, thinking about an email, a text or a meeting in six hours.
Dr. Claman said smartphones in the bedroom have led to a rise in sleep-related complaints from his patients. "For people I see in their 20s and 30s, the phone is becoming a more common contributing factor to insomnia," he said.
Some large, long-term studies on sleep disorders in the United Kingdom and Finland have found that stress-related issues have led to a rise in insomnia over the last decade. In the United States, according to the National Center on Sleep Disorders Research at the National Institutes of Health, as many as 40 percent of Americans suffer from insomnia in a given year. Ten to 15 percent have chronic insomnia.
All these sleep interruptions lead to work problems. A 2011 study by the American Academy of Sleep Medicine found that insomnia costs $2,280 in lost productivity per American worker every year. That adds up to $63 billion a year for the nation.
The draw of the smartphone is understandable. The alarm clock is a free feature. It's also incredibly convenient — who doesn't like being able to speak to their phone and say, "Wake me up at 7am"?
Many Americans do like it, and they increasingly have brought their smartphones into their bedrooms. A 2013 Facebook-sponsored study by IDC Research found that 44 percent of the people who own a smartphone said they use it as an alarm clock. That number rose to 54 percent for people 18 to 24.
Device makers are helping the trend along and hoping these figures rise. Most new alarm clocks made today are designed to be married to a smartphone.
This goes against years of research showing that screens, in any capacity, do everything but help us fall asleep. In 2012, the American Medical Association's Council on Science and Public Health said that "exposure to excessive light at night, including extended use of various electronic media, can disrupt sleep or exacerbate sleep disorders."
Sleep researchers say that looking at a blue light, which is produced by smartphone and tablet screens, sets off brain receptors that are designed to keep us awake and interferes with circadian sleep patterns. Experimental research has found that if people use a tablet for up to two hours before bed, it takes an extra hour to fall asleep.
Orfeu M. Buxton, a neuroscientist and assistant professor in the division of sleep medicine at Harvard Medical School, said the phone in the bedroom could set off what he called "threat vigilance," which is a type of anxiety that keeps you awake. "This means that you're never off, you're always watchful, which is a hallmark to insomnia," he said.
Teens fare the worst. Some children in middle school not only bring their phone into the bedroom but also leave the ringer on. "I have found that 10 or 15 percent of teens in middle school are hardened insomniacs that not only sleep with their cellphones on but feel they have to be responsive to intrusion, in case a friend is in need," Buxton said.
This I know: Little good comes from looking at your phone at 3 a.m. So for now, my bedroom rule is this: No gadgets allowed.
Except my new alarm clock. It has no apps or Wi-Fi, but it wakes me up in the morning, not in the middle of the night.
11th Feb 2014, 07:35 PM #799
Re: Health Bulletin
New high-tech glasses help doctors 'see' cancer
Scientists have developed new high-tech glasses that may help surgeons visualise cancer cells which glow blue when viewed through the eye-wear.
Cancer cells are notoriously difficult to see, even under high-powered magnification, researchers said.
The glasses are designed to make it easier for surgeons to distinguish cancer cells from healthy cells, helping to ensure that no stray tumour cells are left behind during surgery.
"We're in the early stages of this technology, and more development and testing will be done, but we're certainly encouraged by the potential benefits to patients," said breast surgeon Julie Margenthaler, an associate professor of surgery at Washington University.
"Imagine what it would mean if these glasses eliminated the need for follow-up surgery and the associated pain, inconvenience and anxiety," said Margenthaler.
Current standard of care requires surgeons to remove the tumour and some neighbouring tissue that may or may not include cancer cells, researchers said.
The samples are sent to a pathology lab and viewed under a microscope. If cancer cells are found in neighbouring tissue, a second surgery often is recommended to remove additional tissue that also is checked for the presence of cancer.
The glasses could reduce the need for additional surgical procedures and subsequent stress on patients, as well as time and expense.
Margenthaler said about 20 to 25 per cent of breast cancer patients who have lumps removed require a second surgery because current technology doesn't adequately show the extent of the disease during the first operation.
"Our hope is that this new technology will reduce or ideally eliminate the need for a second surgery," she said.
The technology, developed by a team led by Samuel Achilefu, professor of radiology and biomedical engineering at Washington University, incorporates custom video technology, a head-mounted display and a targeted molecular agent that attaches to cancer cells, making them glow when viewed with the glasses.
Researchers noted that tumours as small as one mm in diameter could be detected.
In pilot studies conducted on lab mice, the researchers utilised indocyanine green, a commonly used contrast agent approved by the US Food and Drug Administration.
When the agent is injected into the tumour, the cancerous cells glow when viewed with the glasses and a special light.
The study was published in the Journal of Biomedical Optics.
12th Feb 2014, 12:20 PM #800
Re: Health Bulletin
In a breakthrough, scientists take first ever 3D film of a living sperm
In a major breakthrough, scientists have successfully taken the first 3D movie of a living sperm.
To improve their chances of success, in vitro fertilization (IVF) clinics need to assess the viability of the sperm they use.
Now doctors may soon have a new technique to help them sort the good sperm cells from the less viable ones — a tracking system, developed by a team of researchers from four European institutions, that takes 3D movies of living sperm.
In addition to showing the sperm's movement and behavior in real time, the novel method simultaneously provides detailed 3D imaging of the sperm's form and structure to detect potential infertility-causing anomalies, such as the "bent tail" that prevents the cells from swimming straight.
In their new technique, the team of researchers from Italy and Belgium combined microscopy and holography — the creation of 3D images.
"By acquiring a video of the moving sperm in 3D, we add a fourth dimension - time," said lead author Giuseppe Di Caprio of the Institute for Microelectronics and Microsystems of the National Research Council (NRC) in Naples, Italy and Harvard University in Cambridge, Mass.
The researchers say this is the first technique for collecting data on sperm cell motility—a key predictor of IVF success—in three dimensions and over time. Currently, sperm concentration and mobility in semen are assessed either by subjective visual evaluation or a process known as computer-assisted sperm analysis (CASA). While the latter provides more detail and fewer errors than the former, CASA still only allows tracking and imaging in two dimensions.
To achieve their new tracking system, the researchers first separated laser light into two beams. They transmitted one beam through a dish containing live, swimming sperm cells and then recombined it, after magnification through a microscope, with the second beam.
Di Caprio says that the 3D imaging technique, known formally as digital holographic microscopy (DHM), yields morphology and motility data on sperm consistent with that found in previous studies, but with the unprecedented bonus of seeing cause and effect relationships between the two.
"For example," Di Caprio said, "we found that most of the sperm cells we observed swim along in one plane as expected. However, with the more detailed analysis provided by DHM, we also were able to show that this 'in-plane' movement - which we believe is linked to higher potential for fertility—does not occur when there are morphological anomalies such as sperm with misshapen heads or 'bent tails.'"