28 February 2011
'Whoonga' threat to South African HIV patients
HIV patients in the South African township of Umlazi live in fear of being robbed of their live-saving anti-retroviral drugs.
They have become attractive targets for gangs who steal their pills, which are then combined with detergent powder and rat poison to make "whoonga" - a highly toxic and addictive street drug.
Smokers use it to lace joints, believing the anti-retroviral Stocrin increases the hallucinogenic effects of marijuana - though there is no scientific proof of this.
We have to worry about thugs who will want to rob us for a chance to live ”End Quote Patient Phumzile Sibiya
The threat to HIV patients in this poor community of KwaZulu-Natal province is very real.
"On the one hand, we are battling to stay alive," says 49-year-old Phumzile Sibiya, who has been taking ARV drugs for six months.
"Now we have to worry about thugs who will want to rob us for a chance to live because that's what they are stealing from us when they take our pills."
Ms Sibiya and other HIV patients now visit the clinic in a group to ensure their safety.
"I just don't feel safe at all when I come to collect my pills. You never know where they could be waiting for you. This is very painful," she says as she shuffles along a long queue at Ithembalabantu Clinic, south of Durban
They have become attractive targets for gangs who steal their pills, which are then combined with detergent powder and rat poison to make "whoonga" - a highly toxic and addictive street drug.
Smokers use it to lace joints, believing the anti-retroviral Stocrin increases the hallucinogenic effects of marijuana - though there is no scientific proof of this.
We have to worry about thugs who will want to rob us for a chance to live ”End Quote Patient Phumzile Sibiya
The threat to HIV patients in this poor community of KwaZulu-Natal province is very real.
"On the one hand, we are battling to stay alive," says 49-year-old Phumzile Sibiya, who has been taking ARV drugs for six months.
"Now we have to worry about thugs who will want to rob us for a chance to live because that's what they are stealing from us when they take our pills."
Ms Sibiya and other HIV patients now visit the clinic in a group to ensure their safety.
"I just don't feel safe at all when I come to collect my pills. You never know where they could be waiting for you. This is very painful," she says as she shuffles along a long queue at Ithembalabantu Clinic, south of Durban
**Published by BBC News Health
Gene fuelled transporter causes breast cancer cells to self-destruct
Scientists at Queen's University Belfast have shown that they can deliver a gene directly into breast cancer cells causing them to self-destruct, using an innovative, miniscule gene transport system, according to research published today (28 February) in the International Journal of Pharmaceutics. Using a transport system called a Designer Biomimetic Vector (DBV), Dr Helen McCarthy, from Queen's School of Pharmacy, funded by Breast Cancer Campaign, packaged a gene into a nanoparticle 400 times smaller than the width of a human hair, allowing it to be delivered straight into breast cancer cells in the laboratory.
The gene called iNOS, is targeted specifically to breast cancer cells using the DBV where it forces the cells to produce poisonous nitric oxide; either killing the cells outright or making them more vulnerable to being destroyed by chemotherapy and radiotherapy. As this approach leaves normal healthy breast cells unaffected, this would overcome many of the toxic side effects of current treatments.
Further investigation is needed but it could be trialled in patients in as little as five years. Dr McCarthy's next step is to turn the nanoparticles into a dried powder that could be easily transported and reconstituted before being given to patients.
Dr McCarthy said: "A major stumbling block to using gene therapy in the past has been the lack of an effective delivery system. Combining the Designer Biomimetic Vector with the iNOS gene has proved successful in killing breast cancer cells in the laboratory. In the long term, I see this being used to treat people with metastatic breast cancer that has spread to the bones, ideally administered before radiotherapy and chemotherapy."
Dr Lisa Wilde, Research Information Senior Manager, Breast Cancer Campaign said: "Gene therapy could potentially be an exciting avenue for treating breast cancer. Although at an early stage, Dr McCarthy's laboratory research shows that this system for delivering toxic genes to tumour cells holds great promise and we look forward to seeing how it is translated into patients."
*Source: Queen's University Belfast
The gene called iNOS, is targeted specifically to breast cancer cells using the DBV where it forces the cells to produce poisonous nitric oxide; either killing the cells outright or making them more vulnerable to being destroyed by chemotherapy and radiotherapy. As this approach leaves normal healthy breast cells unaffected, this would overcome many of the toxic side effects of current treatments.
Further investigation is needed but it could be trialled in patients in as little as five years. Dr McCarthy's next step is to turn the nanoparticles into a dried powder that could be easily transported and reconstituted before being given to patients.
Dr McCarthy said: "A major stumbling block to using gene therapy in the past has been the lack of an effective delivery system. Combining the Designer Biomimetic Vector with the iNOS gene has proved successful in killing breast cancer cells in the laboratory. In the long term, I see this being used to treat people with metastatic breast cancer that has spread to the bones, ideally administered before radiotherapy and chemotherapy."
Dr Lisa Wilde, Research Information Senior Manager, Breast Cancer Campaign said: "Gene therapy could potentially be an exciting avenue for treating breast cancer. Although at an early stage, Dr McCarthy's laboratory research shows that this system for delivering toxic genes to tumour cells holds great promise and we look forward to seeing how it is translated into patients."
*Source: Queen's University Belfast
La limpieza y drenaje son fundamentales para lograr la curación de una herida infectada
La limpieza y drenaje de una herida infectada resultan determinantes para conseguir su curación, con independencia del antibiótico que se utilice para combatir la presencia de bacterias, tal como indica un estudio en niños llevado a cabo por investigadores del Centro Infantil Johns Hopkins, en Estados Unidos, y publicado en el último número de la revista "Pediatrics".
Esta investigación, en la que participaron casi 200 niños, estaba inicialmente enfocada a comparar la eficacia de dos antibióticos utilizados de forma habitual para tratar infecciones en la piel, la cefalexina y la clindamicina, que han demostrado funcionar bien contra las bacterias más resistentes a fármacos. Sin embargo, los autores del estudio observaron que la clave de la curación estaba en el cuidado de las heridas más que en la selección de uno u otro antibiótico.
"No importó el antibiótico utilizado", señaló el principal investigador del estudio, Aaron Chen, ya que con ambos fármacos las infecciones se superaron en una semana. En cambio, "cuando se limpiaba bien la zona afectada, se realizaba un drenaje y se vendaba bien, la curación era más rápida", explicó. El cuidado de las heridas infectadas en la piel era suficiente en la mayoría de casos, si bien en los últimos años "hay médicos que comienzan a prescribir antibióticos de forma preventiva", recordó Chen.
Los autores del trabajo están satisfechos con los resultados de esta investigación porque el uso de antibióticos "puede tener efectos secundarios graves", al tiempo que "aumenta el coste asistencial" en estos casos. En concreto, los 191 niños que participaron en este estudio tenían entre seis meses de edad a 18 años, de los cuales 133 se habían infectado con el "staphylococcus aureus" resistente a la meticilina (SARM), mientras que el resto mostraban una infección por otras bacterias no resistentes.
**Agencias
Esta investigación, en la que participaron casi 200 niños, estaba inicialmente enfocada a comparar la eficacia de dos antibióticos utilizados de forma habitual para tratar infecciones en la piel, la cefalexina y la clindamicina, que han demostrado funcionar bien contra las bacterias más resistentes a fármacos. Sin embargo, los autores del estudio observaron que la clave de la curación estaba en el cuidado de las heridas más que en la selección de uno u otro antibiótico.
"No importó el antibiótico utilizado", señaló el principal investigador del estudio, Aaron Chen, ya que con ambos fármacos las infecciones se superaron en una semana. En cambio, "cuando se limpiaba bien la zona afectada, se realizaba un drenaje y se vendaba bien, la curación era más rápida", explicó. El cuidado de las heridas infectadas en la piel era suficiente en la mayoría de casos, si bien en los últimos años "hay médicos que comienzan a prescribir antibióticos de forma preventiva", recordó Chen.
Los autores del trabajo están satisfechos con los resultados de esta investigación porque el uso de antibióticos "puede tener efectos secundarios graves", al tiempo que "aumenta el coste asistencial" en estos casos. En concreto, los 191 niños que participaron en este estudio tenían entre seis meses de edad a 18 años, de los cuales 133 se habían infectado con el "staphylococcus aureus" resistente a la meticilina (SARM), mientras que el resto mostraban una infección por otras bacterias no resistentes.
**Agencias
El hospital Clínic y el Hospital Vall d'Hebron de Barcelona operan melanomas con cámaras GPS para ganar precisión
El hospital Clínic y el Vall d'Hebron de Barcelona han probado, por primera vez en España, una cámara portátil, que utiliza rayos infrarrojos, una sonda y un posicionador para generar en tiempo real una imagen 3D del tumor y del ganglio mientras se efectúa el rastreo encima de la piel del paciente, lo que permite determinar con enorme precisión la zona exacta que debe ser seccionada.
Los pacientes operados con esta nueva cámara pueden recibir el alta a las 24 horas de la operación, o incluso ser intervenidos de forma ambulatoria.
Esta nueva técnica es efectiva para tratar tumores donde la diseminación es muy irregular, ya que los cirujanos pueden eliminar casi todo el ganglio susceptible de producir metástasis, y evitan la extracción de ganglios sanos en zonas difíciles como medida preventiva, como se hace con cirugía convencional.
**Agencias
Los pacientes operados con esta nueva cámara pueden recibir el alta a las 24 horas de la operación, o incluso ser intervenidos de forma ambulatoria.
Esta nueva técnica es efectiva para tratar tumores donde la diseminación es muy irregular, ya que los cirujanos pueden eliminar casi todo el ganglio susceptible de producir metástasis, y evitan la extracción de ganglios sanos en zonas difíciles como medida preventiva, como se hace con cirugía convencional.
**Agencias
Advanced degrees add up to lower blood pressure
Freshmen on the eve of finals and graduate students staring down a thesis committee may not feel this way, but the privilege of obtaining an advanced education correlates with decades of lower blood pressure, according to a study led by a public health researcher at Brown University. The benefit appears to be greater for women than for men. Eric Loucks, assistant professor of community health, says the analysis of nearly 4,000 patient records from the 30-year Framingham Offspring Study may help explain a widely documented association in developed countries between education and lower risk of heart disease. The paper was published online in the open access journal BMC Public Health.
"Does education influence heart disease?" said Loucks, who came to Brown in 2009 from McGill University in Montreal, where he did his analysis. "One of the ways to get at that is to see if education is related to the biological underpinnings of heart disease, and one of those is blood pressure." ´
-The difference education makes
Controlling just for age, Loucks and his co-authors found that women who completed 17 years of schooling or more had systolic blood pressure readings that were, on average, 3.26 millimeters of mercury (mmHg) lower than women who did not finish high school. Women who went to college, but did not pursue graduate studies, had a 2 mmHg benefit compared to less educated women. For men, going to graduate school versus not finishing high school made a 2.26 mmHg difference, with a lesser benefit for going to college.
Even after controlling for influences such as smoking, drinking, obesity and blood pressure medication, the benefit persisted, although at a lower level (graduate school gave a benefit of 2.86 mmHg for women and 1.25 mmHg for men).
Loucks then went even further in his analysis by indexing the blood pressure readings to make them all equal at the beginning of the 1971-2001 Framingham study period. This statistical maneuver allowed him to determine whether the analysis measured a static difference apparent early on in life or whether the differences increased at all over time. For women, they did. The most educated group retained a 2.53 mmHg benefit over the least educated. In men, the difference was much less, only 0.34 mmHg.
That the gender differences are so pronounced and appear to become more so as life goes on suggests that education may have a greater impact on women's health over their lifetime than on men's health, Loucks said. That could be because of the correlation between low educational attainment and other health risk factors found in other studies of women.
"Women with less education are more likely to be experiencing depression, they are more likely to be single parents, more likely to be living in impoverished areas and more likely to be living below the poverty line," Loucks said.
One caveat, he said, is that the population in the study, drawn from the suburban community of Framingham, Mass., decades ago, is disproportionately white and that the conclusions might not generalize to other races.
-Education and public health
Loucks said the study adds to a chorus of others suggesting that policy makers who want to improve public health and are struggling to do it in other ways, might want to look at improving access to education.
"Socioeconomic gradients in health are very complex," he said. "But there's the question of what do we do about it. One of the big potential areas to intervene on is education."
**Source: Brown University
"Does education influence heart disease?" said Loucks, who came to Brown in 2009 from McGill University in Montreal, where he did his analysis. "One of the ways to get at that is to see if education is related to the biological underpinnings of heart disease, and one of those is blood pressure." ´
-The difference education makes
Controlling just for age, Loucks and his co-authors found that women who completed 17 years of schooling or more had systolic blood pressure readings that were, on average, 3.26 millimeters of mercury (mmHg) lower than women who did not finish high school. Women who went to college, but did not pursue graduate studies, had a 2 mmHg benefit compared to less educated women. For men, going to graduate school versus not finishing high school made a 2.26 mmHg difference, with a lesser benefit for going to college.
Even after controlling for influences such as smoking, drinking, obesity and blood pressure medication, the benefit persisted, although at a lower level (graduate school gave a benefit of 2.86 mmHg for women and 1.25 mmHg for men).
Loucks then went even further in his analysis by indexing the blood pressure readings to make them all equal at the beginning of the 1971-2001 Framingham study period. This statistical maneuver allowed him to determine whether the analysis measured a static difference apparent early on in life or whether the differences increased at all over time. For women, they did. The most educated group retained a 2.53 mmHg benefit over the least educated. In men, the difference was much less, only 0.34 mmHg.
That the gender differences are so pronounced and appear to become more so as life goes on suggests that education may have a greater impact on women's health over their lifetime than on men's health, Loucks said. That could be because of the correlation between low educational attainment and other health risk factors found in other studies of women.
"Women with less education are more likely to be experiencing depression, they are more likely to be single parents, more likely to be living in impoverished areas and more likely to be living below the poverty line," Loucks said.
One caveat, he said, is that the population in the study, drawn from the suburban community of Framingham, Mass., decades ago, is disproportionately white and that the conclusions might not generalize to other races.
-Education and public health
Loucks said the study adds to a chorus of others suggesting that policy makers who want to improve public health and are struggling to do it in other ways, might want to look at improving access to education.
"Socioeconomic gradients in health are very complex," he said. "But there's the question of what do we do about it. One of the big potential areas to intervene on is education."
**Source: Brown University
Hearing loss rate in older adults climbs to more than 60 percent in national survey
Nearly two-thirds of Americans age 70 and older have hearing loss, but those who are of black race seem to have a protective effect against this loss, according to a new study led by Johns Hopkins and National Institute on Aging researchers. These findings, published online Feb. 28 in the Journal of Gerontology: Medical Sciences, provide what is believed to be the first nationally representative survey in older adults on this often ignored and underreported condition. Contrary to the view that hearing loss is of only minor importance in old age, study leader Frank Lin, M.D., Ph.D., assistant professor in the Division of Otology at Johns Hopkins University School of Medicine and a core faculty member in the Johns Hopkins Center of Aging and Health, says studies including his own have strongly linked it to other health problems, such as cognitive decline, dementia, and poorer physical functioning. And he notes that relatively little is known about risk factors that drive hearing loss.
To fill in some of the blanks, Lin and his colleagues analyzed data from the 2005-2006 cycle of the National Health and Nutrition Examination Survey, a research program that has periodically gathered health data from thousands of Americans since 1971. In the 2005-2006 cycle, the hearing of participants 70 years or older was checked using a test that determined whether they could detect tones in frequencies used in speech.
When the researchers analyzed the numbers from 717 volunteers, they found that about 63 percent had hearing loss that ranged from mild to severe. Mixing in demographic data showed that those who were older or male were more likely to have hearing loss or more severe hearing loss than younger or female subjects. The researchers also found that being black appeared to be protective. While about 64 percent of white subjects had hearing loss, only about 43 percent of black subjects did. After accounting for other factors that are associated with hearing loss like age and previous noise exposure, black participants had only a third of the chance of having hearing loss when compared with white participants.
Lin notes that he and his colleagues aren't sure why being black might prevent hearing loss, but they and other research teams have suggested that pigment produced by cells in the skin and inner ear might protect the inner ear by absorbing free radicals, among other mechanisms.
Despite the overwhelming number of older adults with hearing loss, the study found that only one-fifth use hearing aids, with only 3 percent of those with mild hearing loss taking advantage of these devices.
"Any way you cut it, the rates of hearing aid use are phenomenally low," Lin says. He and his colleagues are currently planning a study to see whether hearing aid use could prevent some of the conditions connected to hearing loss.
*Source: Johns Hopkins Medical Institutions
To fill in some of the blanks, Lin and his colleagues analyzed data from the 2005-2006 cycle of the National Health and Nutrition Examination Survey, a research program that has periodically gathered health data from thousands of Americans since 1971. In the 2005-2006 cycle, the hearing of participants 70 years or older was checked using a test that determined whether they could detect tones in frequencies used in speech.
When the researchers analyzed the numbers from 717 volunteers, they found that about 63 percent had hearing loss that ranged from mild to severe. Mixing in demographic data showed that those who were older or male were more likely to have hearing loss or more severe hearing loss than younger or female subjects. The researchers also found that being black appeared to be protective. While about 64 percent of white subjects had hearing loss, only about 43 percent of black subjects did. After accounting for other factors that are associated with hearing loss like age and previous noise exposure, black participants had only a third of the chance of having hearing loss when compared with white participants.
Lin notes that he and his colleagues aren't sure why being black might prevent hearing loss, but they and other research teams have suggested that pigment produced by cells in the skin and inner ear might protect the inner ear by absorbing free radicals, among other mechanisms.
Despite the overwhelming number of older adults with hearing loss, the study found that only one-fifth use hearing aids, with only 3 percent of those with mild hearing loss taking advantage of these devices.
"Any way you cut it, the rates of hearing aid use are phenomenally low," Lin says. He and his colleagues are currently planning a study to see whether hearing aid use could prevent some of the conditions connected to hearing loss.
*Source: Johns Hopkins Medical Institutions
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