'Tangible Progress' Reported in Control of TB in SE Asia

VOA News 24/03/2010

The World Health Organization has taken the occasion of World TB Day to document the progress and challenges in its fight against tuberculosis in its Southeast Asia region.

Picture: Tuberculosis patient Supachai Sengsum on his bed at Wat Prabat Nampu in Lopburi, Thailand (2009 File)

The United Nations health body warns it faces several challenges in its TB programs in the region. The World Health Organization says it main tasks are to sustain and expand services to countries struggling with poverty, rapid urbanization and large population displacements.

India accounts for 20 percent of all global tuberculosis cases. And while the overall death rate has been on the decline in the 11 countries in the WHO's Southeast Asia region, it is responsible for half a million deaths each year.

The region is composed of Bangladesh, Bhutan, India, Indonesia, Maldives, Burma, Nepal, Sri Lanka, Thailand and East Timor.

WHO officials are particularly concerned by data showing more than a third of patients getting repeat treatments in Thailand have multi-drug resistant TB. India has the highest such number of cases globally. Multi-drug resistant TB is much harder to treat successfully.

Australian scientists in TB drug breakthrough

Bangkok Post 24/03/2010

Australian scientists said Wednesday they had discovered a drug which could cure tuberculosis at its non-infectious stage and could be the first major breakthrough on the disease in 50 years.

Bacteriologist Nick West said researchers at Sydney's Centenary Institute had developed a drug which could essentially combat the disease before it takes hold, potentially saving millions of lives around the world.

"We have investigated a protein that is essential for TB to survive and we have had some success in developing a drug that will inhibit this protein," said West.

"Our goal over the coming months is to find out the full extent of this drug's potential."

West said it would be the first time in history that dormant or asymptomatic, non-infectious TB would be able to be treated, potentially stemming a deadly tide of infection which claimed two million lives every year.

"Unfortunately, the antibiotics we use to fight TB aren't effective against latent TB and can only be used when the disease becomes active," he explained.

"This is a major problem as one out of 10 people who have latent TB will develop the active disease, becoming sick and contagious."

"If we can figure out a way to treat TB when it's in a latent stage, then we could save millions of lives throughout the world," West added.

If successful the drug would be the the first new treatment for TB since 1962, according to the institute which is affiliated with the University of Sydney.

One third of the world's population, or two billion people, are estimated to be infected with TB, with the disease growing fastest in South East Asia.

Lethal multidrug-resistant strains of the disease were becoming a serious threat to global health, infecting almost half a million people in 2008, of whom one-third died, the World Health Organisation warned last week.

Almost half the drug resistant cases were estimated to have occurred in India and China, the WHO said, with an extensively drug-resistant form, found in 58 countries, "virtually untreatable".

How to Survive a Heart Attack

VOA News 23/03/2010

When a heart attack occurs outside of a hospital, death is frequently the outcome, but a new study has shown that rapid intervention using two strategies can increase the chances for survival.

Emergency physician Arthur Kellermann, a senior principal researcher at the Rand Corporation, says the single most effective way to save a heart attack patient's life is for someone to do cardiopulmonary resuscitation, or CPR.

"Bystander CPR is easy to learn, easy to remember and easy to perform. You can save lives with CPR by just pumping on the chest, you don't even have to do mouth-to-mouth breathing."

Electronic devices called Automated External Defibrillators, or AEDs, can also help save a heart attack victim's life.

"Automated External Defibrillators allow a citizen with little or no training to apply that counter shock to a patient and potentially restart their heart." Kellermann adds that the sooner the AED is used, the more likely the heart is to restart.

Lessons for successful emergency response

Although clinically AEDs have been shown to be effective, it was unclear whether having them publicly available in places like schools, workplaces and sports facilities would improve community survival rates following cardiac arrests.

Vitamin D May Protect Against Heart Attack

VOA News 23/03/2010

Vitamin D is an essential nutrient that we get through exposure to sunlight and through diet. Without enough Vitamin D, we are at risk for rickets, osteoporosis and bone fractures.

Now, researchers have found that Vitamin D deficiency is also associated with increased risk for cardiovascular disease.

J. Brent Muhlestein, a cardiologist at the Intermountain Medical Center in Salt Lake City, Utah, looked at Vitamin D levels in 41,000 patients who visited the medical center for various health problems. He found that about two-thirds of them had low levels of Vitamin D.

"We found a significant association with future heart attacks and strokes and death in the patients who were low compared to ones who were not low in that blood test," says Muhlestein.

Over the next twelve months, one group took Vitamin D supplements to get up to normal levels. The other group did not. At the end of the year, Muhlestein tested both groups again.

Religious Leaders to Fight HIV Stigma

VOA News 23/03/2010

Spiritual leaders from around the world are meeting in The Netherlands to discuss their response to HIV/AIDS. Selah Hennessy spoke to African church leaders for VOA about how they can use their influence to fight the stigma surrounding the disease.

Reverend Patricia Sawo is a pastor at the Calvary Celebration Church in Kenya and the mother of 10 children.

Sawo found out she was HIV positive more than a decade ago. She says before then she had been misinformed about the disease.

"Before I was confronted with my own HIV status, I knew that HIV was a disease for the sinners, and that is how it was presented," she said.

When she learned she was HIV-positive she lost her position in the church. But she learned more about HIV/AIDS and has retaken charge of her church and says she aims to teach her congregation the facts.

"There were people already in the church who were actually having HIV and who were hopeless and did not have anywhere to turn to," she said. "So my coming back into the church with the good news in itself started an automatic support group within the church. That Sunday that I spoke in the Sunday service, in the evening there were eight people who came to confide in me and just to tell me that they were there and they were living with HIV and we needed to find more information," she explained.

Agreement to Provide Pneumonia Vaccine to Poor Children Expected to Save Millions of Lives

VOA News 23/03/2010

The GAVI Alliance and two leading pharmaceutical companies have signed an agreement to provide low-cost life-saving vaccines to millions of the world's poorest children. Each year, the World Health Organization reports an estimated two million children under age five die of pneumonia. This disease is responsible for about one-quarter of all child deaths.

GAVI Alliance CEO Julian Lob-Levyt says pneumonia kills more than AIDS, malaria and measles combined. "And more than 90 percent of those deaths occur in developing countries. So, today, I am very proud to announce that GAVI is signing a landmark agreement with GSK (GlaxoSmithKline) and Pfizer to provide long-term supplies of a revolutionary new vaccine against this major killer of children," she said.

The Geneva-based public-private alliance, and GlaxoSmithKline and Pfizer say supplies of the new vaccine to Africa and other developing countries will start early this year at a fraction of the price charged in industrialized countries.

Lob-Levyt says cost is the major reason why the vaccine has been unavailable to children in the poorest countries.

Potent Jungle Vine Brew Has Potential to Treat Addiction

VOA News 23/03/2010

New research suggests ayahuasca, a jungle vine found in the Peruvian rainforest, can have a powerful effect on the human central nervous system when brewed with other plants. Researchers say one of ayahuasca's most promising uses could be in treating drug and alcohol addiction.

According to the World Health Organization, medicines derived from plants play a major role in the health care of 80 percent of the world's population. Western medicine has synthesized many of these natural drugs, from the painkillers in willow bark to the anti-cancer compounds in the neem tree, and is constantly searching for more pharmaceuticals in the biodiversity of the world's forests.

Ayahuasca is one traditional plant-based medicine that has drawn the attention of investigators. In the South American jungles, it is used in religious ceremonies to induce visions and also as a remedy to cure ills.

At the Onanyan Shobo spiritual retreat center in the rainforest near Iquitos, Peru, shaman Alfredo Kayruna Canayo shows off a section of the twisting, leafy vine. "What ayahuasca means is vine of the dead," he explains through an interpreter. "Some people call it soul vine."

Ayahuasca is known as a master plant, a very powerful remedy that treats the whole person: body, mind, and soul. "The ayahuasca [can] cure anything you have," the shaman says. "Start with simple things. For example, it's very simple to cure or repel the bad energies from your insides. What is the bad energy? One of them could be the fears, then some wound or injury you have."

Whether the plant is being used for religious or medicinal purposes, ayahuasca is taken only in a ceremonial setting under the direction of an experienced shaman. To turn it into a drink, also called ayahuasca, pieces of the vine are pounded into a pulp and combined with several other plants, then brewed down for eight or more hours into a thick orange liquid.

Live Kidney Donation Safe For Donor

VOA News 11/03/2010

Most of the studies on kidney donation focus on the recipients and how well they adjust to their new kidneys. A new study documents how well donors fare after the surgery.

Kidneys are the most sought after donor organs around the world, according to the World Health Organization. To address the shortage, some hospitals have created programs that pair prospective donors with recipients.

In 2006, the Johns Hopkins University Hospital held a news conference to announce a successful operation involving 10 people: five donors and five recipients.

Dr. Dorry Segev was one of the surgeons. He outlined the problem in an interview with VOA. "Every year we list more and more people for a kidney transplant and that's because more and more people are developing kidney failure, more people are becoming candidates for a transplant," he stated.

People often become donors because a loved one needs a kidney. Some do it for altruistic reasons. That was Judy Payne's motive. "It didn't seem to be that hard of a decision. I like to give to others. I like to share what I can of my blessings," she said.

Dr. Segev studied more than 80,000 live kidney donors from the time of surgery until three months afterwards. "What we found is that live donation is very safe, the risk of dying from donating a kidney is 3 in 10,000 which is much lower than the risk of almost any other operation that you can undergo."

Fruit Flies Could Unlock Mystery of Alzheimer's

VOA News 16/03/2010

At Scripps Research Institute in Jupiter, Florida, scientists are working to find clues about how the human brain processes memories. Their laboratory test animal is not a chimp or a dog or a rat — animals that we know can remember things — it is the common fruit fly.

"They're relatively simple," Ron Davis says, explaining why the fruit fly's brain has some ideal properties for human brain research. "The brain of the fruit fly has about 100,000 neurons. The brain of a human has about 100 billion neurons, and that's an enormous network of interconnected neurons in the human brain, if one thinks about it. We literally can't wrap our brains around the human brain yet."

Fruit fly training regimen

Davis chairs the Department of Neuroscience at Scripps Florida. He's designed an experiment in which fruit flies are trained to remember an odor associated with an unpleasant electrical shock.

Dr. Ron Davis says fruit flies have essentially the same genes as humans do, just fewer of them.

It involves a series of Plexiglas tubes which have an electrifiable copper grid on their surfaces. "One puts the fly in these tubes first, passes an odor through the tube," Davis says. "Odor A shocks the animal, mild electric shock." After fresh air has been blown through the tubes to remove any trace of the first odor, a second scent is pumped in.

"Odor B passes through the tube and the animals are not shocked. That's the training where we're hoping the animals will develop an association. They'll learn that one odor is bad because it's been punished in the presence of that odor. And the other odor is okay."

 Then, the flies are tested to see how well they remember which odor is which. Davis says about 90 percent do, and avoid the electric shock. The ones that don't are isolated, so their genes can be studied.

VOA News 10/03/2010

 

Glaucoma is the leading cause of irreversible loss of vision worldwide and now doctors believe the devastating disease begins in the brain and not in the eye as has long been thought.

Dr. David Calkins, director of research at the Vanderbilt Eye Institute in Tennessee, quotes estimates that by the year 2020, there will be 80 million cases of glaucoma worldwide.

Glaucoma is called the 'silent thief of sight,' since most people with the disease don't notice a change in their vision. It happens gradually, as increased fluid pressure inside the eye, known as ocular pressure, damages the optic nerve, which sends visual images to the brain. Damaged nerve cells cannot be replaced or repaired.

There is currently just one treatment for glaucoma, which is to reduce ocular pressure. Doctors test for glaucoma by measuring pressure inside the eye and checking peripheral vision.

But Calkins and his colleagues have discovered that the earliest signs of glaucoma are not in the eye, but in the brain.

A new understanding of the disease progression

"We don't really understand why it is that there is a loss of communication at the brain first," Calkins says, adding that it is now clear the degeneration of vision starts in the brain and works its way back to the retina, rather than the other way around.

The finding suggests that glaucoma may be reversible in the early stages, since the nerve structures between the brain and the optic nerve do not degenerate right away. "The structure that allows the communication remains in place for a very, very long time," Calkins says.

And that, he says, opens up new ways to treat glaucoma and puts it in an entirely new perspective.

"Instead of treating it just as a disease of the eye, we now understand that it is really a neurological disease that involves loss of communication between the optic nerve and the brain." And, by studying glaucoma as a neurological disease, Calkins says researchers may be able to learn more about other age-related neuro-degenerative disorders like Alzheimer's and Parkinson's disease.

The study appeared in the "Proceedings of the National Academy of Sciences."

Drug Maker Accused of False Advertising

VOA News 02/03/2010

A county in the U.S. state of California is suing GlaxoSmithKline, the maker of Avandia, a controversial diabetes drug. The lawsuit was spurred by a report on the drug released by the U.S. Senate last week (March 22). That report accused the drug company of withholding information about side effects of serious heart problems, including death. At issue now is whether Avandia should be taken off the market.

A U.S. Senate report on the diabetes drug Avandia says both the manufacturer, GlaxoSmithKline, and the U.S. Food and Drug Administration should have warned patients about the dangers of the drug years before they did. The report recommends taking Avandia off the market.

In 2007, Dr. Steven Nissen published a study showing that those taking Avandia had a 43 percent higher risk of having a heart attack and a 64 percent greater chance of dying from a heart attack than those not taking the drug. "We've been warning about this for two and a half years," he said. "There really isn't a good reason for physicians to continue to prescribe the drug. It's time to get it off the market."

But doctors still prescribe Avandia to hundreds of thousands of patients worldwide.

Dr. Yasser Ousman at Washington Hospital Center prescribes it for some pre-diabetic patients or those in the early stages of diabetes. "There are a number of drugs that have been tested in these individuals and Avandia is one of them, and actually, it is quite effective in improving the blood sugar, in normalizing the blood sugar or delaying the occurrence of diabetes in these individuals," Dr. Ousman said.

"What bothers me the most is that every month that goes by, more people are harmed by a drug that people simply don't need," Dr. Nissen said. Dr. Nissen's report was based on 42 clinical trials that showed a connection between Avandia and heart problems.

"I think when you look at the information and the statistics from the initial study, the initial paper by Dr. Nissen in 2007, the increase in the risks of heart attacks is actually small," Dr. Ousman points out. He says that many over the counter drugs - aspirin, ibuprofen, acetaminophen or paracetamol - can be toxic if used improperly.

"If you look at the large studies, that were published over the last several years, including a large number of patients comparing Avandia to a placebo or other drugs, there was actually no increase in that risk. That risk was based on smaller studies," Dr. Ousman said.

A study on Avandia funded by GlaxoSmithKline published last year, found no increase in heart attacks. But it found a significant increase in the risk of heart failure where the heart cannot pump enough blood to the organs or muscles. A number of cases resulted in hospitalization or death.

The Food and Drug Administration says it will review Avandia for heart risks and has scheduled a meeting of its advisory panel in July. The agency warns those taking Avandia not to discontinue use without consulting with a doctor.

CT (Computed Tomography) Scan Radiation Draws Concern

VOA News 30/01/2010


Doctors use X-rays to view internal organs, obtain clear images of possible disease and to treat cancer. For years radiation has been used to save lives, but there is growing concern that some patients are getting more than they ask for when they undergo what's called a CT (Computed Tomography) scan. Research has shown that exposure to radiation can cause cancer and some recent studies raise doubts about the overall safety of CT Scans.

Patricia Quirk of Illinois had radiation to treat her endometrial cancer. The radiation killed the cancer. It also killed her by rupturing her bowel. The hospital record shows she was given 50 percent more radiation than she needed.

Her husband, Tom Quirk, says it should never have happened.


"I pray to God that it never happens to anybody again," said Tom Quirk.
More than half of the cancer patients in the U.S. receive radiation as part of their treatment.

The CT (Computed Tomography) Scan is a method often used to diagnose cancer. It exposes a patient to much larger doses of radiation than the usual x-ray.

Heart Pump Could Save Possibly Millions of Lives

VOA News 27/01/2010

The World Health Organization says heart disease kills about 17 million people every year and that it will become the leading cause of death in developing countries. But now, there is some hope. A new device is being marketed that could save countless lives.

Seventy-eight-year-old Richard Stowe has a mechanical pump inside his chest that keeps blood flowing throughout his body. The only evidence is a battery pack and a power line on his side. "The two batteries are feeding power to the controller and then to my chest," he said. "There is no feeling. It just feels very normal like I had no pump."

Stowe is at the forefront of a revolution in the way heart patients are being cared for.

Dr. Leslie Miller at Washington Hospital Center is involved in clinical trials of heart pumps, including this one that the U.S. Food and Drug Administration has approved as a device that can permanently replace the heart for patients who are too old to be considered for a heart transplant.

"Heart failure really begins to increase over the age of 60 when the chances of heart transplantation diminish, so this is going to be a major therapeutic option for a great many patients in the future," Dr. Miller said.

Heart pumps were initially considered a stopgap measure...until a donor heart became available. But the newest pumps are small. They are attached directly to the heart and connected to a battery outside the body.

Breakthrough for Australian Scientists Working on Malaria Vaccine

VOA News 20/01/2010

Researchers in Australia say a group of proteins produced in the human immune system - when infected with malaria - could help lead to the creation of a malaria vaccine. Scientists at Melbourne's Walter and Eliza Hall Institute made the breakthrough.

For decades, scientists around the world have hunted for a vaccine against malaria, which claims one million lives annually.

The mosquito-borne disease kills a child every 30 seconds, with communities in Africa most at risk.

Malaria is caused by a complex parasite that makes it hard to target with a vaccine.

Researchers at the Walter and Eliza Hall Institute in Melbourne say the disease has evolved to thwart the body's natural defenses.

Australian scientists at the institute, however, are optimistic that a vaccine can be created because people living in malaria hotspots eventually build up some immunity against the disease.

New Malaria Vaccine Initiative Aims to Stunt Parasite within Mosquitoes

VOA News 18/01/2010

A new vaccine initiative has been launched to try to prevent the malaria parasite from developing inside mosquitoes.

Malaria kills about one million people every year, most of them children under age five. Researchers say if successful so-called transmission-blocking vaccines could significantly limit the spread of infection. Once a mosquito bites a vaccinated person, it picks up a substance that interferes with parasite growth.

The Malaria Vaccine Initiative, Johns Hopkins Bloomberg School of Public Health and the Sabin Vaccine Institute are collaborating in the effort.

Dr. Rhoel Dinglasan, an assistant professor at Johns Hopkins, says there are different approaches to a malaria vaccine.

“The malaria vaccines that are currently being perused outside of this transmission-blocking vaccine concept are targeted toward different stages of the parasite life cycle. The most advanced malaria vaccine right now, the RTSS vaccine, is targeted toward prevention of liver stage infection,” he says.

Johnson & Johnson accused of drug kickbacks

News Com AU 17/01/2010

JOHNSON & Johnson paid leading US pharmacy group Omnicare to promote its antipsychotic drug Risperdal for elderly patients, the US government alleges in a lawsuit.

According to the Justice Department, which announced the lawsuit on its website, Johnson & Johnson paid Omnicare, which is the largest US pharmacy for nursing homes, to push drugs including Risperdal.

The complaint filed in Boston yesterday targets Johnson & Johnson and its subsidiaries Ortho-McNeil-Janssen Pharmaceuticals and Johnson & Johnson Health Care Systems.

They are accused of paying millions of dollars in kickbacks to Omnicare.

"J&J understood that Omnicare's pharmacists reviewed nursing home patients' charts at least monthly and made recommendations to physicians on what drugs should be prescribed for those patients," the Department of Justice said.

"The government further alleges that J&J knew that physicians accepted the Omnicare pharmacists' recommendations more than 80 per cent of the time, and that J&J viewed such pharmacists as an 'extension of [J&J's] sales force'."

Omnicare entered into a $US98 million ($105.26 million) settlement in November with the government.

Woman, 59, offered

The Sun 17/01/2010

A WOMAN aged 59 is the oldest in Britain to be offered the chance to become an IVF mum.

Susan Tollefsen has beaten guidelines which until now meant over 50s were normally barred from help at British clinics.

Mrs Tollefsen was branded 'too old' once before but went on to have her first child two years ago thanks to IVF docs in Russia.

"To say I was despondent is probably an understatement," she said.

"I was absolutely devastated because I felt sure that there was somebody who could've helped me."

Two years later shock critics have slammed the private London Women's Clinic in exclusive Harley Street which has relaxed the rules and offered her a second chance.

The retired teacher defended her right to have another child - despite turning 60 in October and suffering a catalogue of health problems. She's got a benign brain tumour, lost hearing in her left ear five years ago, has had one knee replaced, the other is dodgy - and she has back trouble.

She said: "I'm still so full of life and healthy at 60 I don't see any reason why I shouldn't be treated. I really want to do it - 110 per cent.

"I think if I had a magic wand and could knock 10, 15, 20 years off my life, I would - but unfortunately I can't."

Rabbits milked to help treat stroke victims

News Com AU 17/01/2010

A contented New Zealand white rabbit can produce 140ml of milk per day

DUTCH scientists have begun creating herds of dairy rabbits to exploit the medical benefits of their milk.

The first commercial milking of rabbits, using specially adapted eight-teat machines, is already taking place at a farm in Holland, reported the Sunday Times.

The rabbits have been genetically modified to include a human gene, which means their milk contains a protein called C1 inhibitor. C1 helps control inflammation in the body, and a lack of it can be highly damaging.

The milk protein is intended to prevent the rejection of transplant organs and tissue damage in survivors of strokes and heart attacks, as well as helping car crash victims who have suffered traumatic bruising to internal organs.

C1 can be harvested from human blood and other animal sources, but is expensive to obtain and carries the risk of contamination and infection with viruses such as AIDS or CJD, the human version of mad cow disease.

Such issues do not arise with milk from the high-tech rabbit farm.

Brain Study Sheds Light on Language Use

VOA News 15/01/2010

A new study on the brain is shedding light on how humans process language. The research, being carried out in San Diego, Boston and New York is helping scientists understand a part of the brain known as Broca's area. The study shows that the brain is more complex than scientists had realized.

This is an X-ray showing electrodes that surgeons use to find and remove the source of seizures (to cure epilepsy), while sparing the source of mental functions like language. In this study, recordings when patients spoke words revealed that one small part of the brain computes the meanings, structure, and sounds of words, separately and in a quick sequence. It is important to note that electrodes are only implanted in people's brains as part of existing and accepted surgical practice. We then get patients' consent to also record from these electrodes for research purposes. Electrodes are never implanted just for research. This image relates to an article that appeared in the October 16, 2009, issue of Science, published by AAAS. The study, by Dr. N.T. Sahin of the University of California, San Diego in La Jolla, Calif., and colleagues, was titled, "Sequential Processing of Lexical, Grammatical, and Phonological Information within Broca's Area."

The medical center at New York University is one of the clinical sites for the study.

Denise Harris, 39, is helping researchers gain a better understanding of the brain. She suffers from epilepsy, and doctors are monitoring her seizures in the hope of performing an operation to minimize them. Her head is bandaged. Wires protruding from the side are attached to electrodes implanted in her brain. Harris says doctors are monitoring her to see whether she is a good candidate for surgery.

"I've been on many medications throughout my life and after a while, they don't work," she said. "I still get seizures. So now, when they remove the part that the seizure is triggered from, it's supposed to stop."

H1N1 Reality Far Lower than Expectations, says British Medical Journal

VOA News 17/01/2010

The British Medical Journal is taking a hard look at H1N1, examining why the flu strain did not become the huge epidemic that many feared it would.

The World Health Organization says the latest estimate indicates 13,000 people around the world have died from H1N1. It says it expects that number to be much larger when the final estimate is released in the coming months. In comparison, the seasonal flu kills about 36,000 people each year in the United States.

BMJ deputy editor Tony Delamothe says, “I think you’re right to say everybody was concerned about the potential for H1N1, but from the vantage point of early January 2010, at least in the U.K., it doesn’t look as if it’s any worse than an average bout of flu,’ he says.

He says after a spike of H1N1 cases in mid-2009 in Britain, reports of flu cases remained steady and then began to decline.

Over 360 deaths from the disease have been reported, but Delamothe says, “Really, flu kills people every year. And it’s really hard to know whether that’s more than an average year for flu mortality.”

Did early warnings and preparedness help?