Severity of H1N1 Influenza Linked to Presence of Streptococcus Pneumoniae
December 30, 2009
The presence of the Streptococcus pneumoniae in samples that can be easily obtained in clinics and emergency rooms may predict risk of severe disease in H1N1 pandemic influenza. Reports that H1N1 pandemic influenza in Argentina was associated with higher morbidity and mortality than in other countries led investigators in the Center for Infection and Immunity (CII) at the Mailman School of Public Health of Columbia University, their colleagues at Argentina’s National Institute of Infectious Diseases (INEI), and Roche 454 Life Sciences to look for viral mutations indicative of increased virulence and for co-infections that could contribute to disease.
Complete genome sequencing of nasopharyngeal samples representing severe or mild disease revealed no evidence of evolution toward a more virulent phenotype or development of antiviral resistance. However, MassTag PCR, a method for sensitive, simultaneous surveillance and differential diagnosis of infectious diseases, found a strong correlation between the presence of Streptococcus pneumoniae and increased risk for severe disease. The findings, which suggest a new strategy for identifying and treating these patients, are currently online in the publication Plos One.
The scientists examined nasopharyngeal samples representing 199 cases of H1N1 pandemic (H1N1pdm) influenza virus infections from Argentina. The sample set included 39 cases classified as severe and 160 cases categorized as mild. “We used a combination of 454 pyrosequencing and classical Sanger sequencing methods to test for viral evolution toward increased virulence. Comparison of viral sequences from Argentina with those obtained from other parts of the world provided no clues to the increase in severity of disease,” said Gustavo Palacios, PhD, assistant professor of epidemiology at CII, and a lead and corresponding author. “However, MassTag PCR allowed us to find a new risk factor, independent of obesity, asthma, diabetes or chronic illness. S. pneumoniae was present in the majority of severe cases.”
Researchers Develop Drug Interface To Save Lives
December 29, 2009
Two University of Alberta researchers say that, as one’s health begins to fail, so does the chances of taking the wrong combination of pills. But they have found a solution to this very common age-related and potentially fatal problem.
Lisa Given and Stan Ruecker, professors in humanities computing, say the drug information software they have developed will allow everyone to research information on drugs that may have been, for example, ingested by accident. For instance, medical practitioners or patients can compare a drug with images from a database to reveal details of the drug’s contents. The researchers say the application they have designed will also help deal with visual and motor impairments, which can make sorting, holding and indentifying pills a challenge as people grow older.
As part of the process of developing their system, Given and Ruecker asked seniors, age 65 and older, to imagine having accidentally dropped and mixed up their pills. Using a sample of about a half-dozen drugs, they say the seniors were able to identify and re-organize the pills when asked to use the interface, which had images and details of more than 1,000 pills in its database. The system has the flexibility to allow for more drugs to be added as they are manufactured.
Bypass Anemia Drugs in Chronic Kidney Disease, Expert Says
December 29, 2009
Anemia in most chronic kidney disease patients should be managed with iron supplements or blood transfusions, if anything, rather than erythrocyte-stimulating agents, a leading nephrologist has recommended.
The only good case for long-term use of erythropoietin drugs in this population is in those who are transplant candidates or have severe anemia with a hemoglobin under 9 g/dl that cannot be managed with transfusions, Ajay K. Singh, of Harvard and Brigham and Women’s Hospital in Boston, concluded.
“Avoiding use of erythrocyte-stimulating agents in managing anemia in nondialysis patients with chronic kidney disease is now the soundest approach,” he wrote in an editorial online in the Journal of the American Society Nephrology.
Vanderbilt Doctors Urge Parents to Preset Volume on Holiday Electronics
December 26, 2009
Parents and children giving or receiving an electronic device with music this holiday season should give their ears a gift as well by pre-setting the maximum decibel level to somewhere between one-half and two-thirds maximum volume.
Any sound over 85 decibels (dBs) exceeds what hearing experts consider to be a safe level and some MP3 players are programmed to reach levels as high as 120 dBs at their maximum.
Roland Eavey, M.D. and Anne Marie Tharpe, PhD., urge parents to preset volume levels on MP3 players. Photo by Susan Urmy
Vanderbilt Bill Wilkerson Center Director Ron Eavey, M.D., who also chairs the Department of Otolaryngology, says the new generation is especially susceptible to hearing loss when they listen to music with headphones or earbuds either too long or too loud.
One preventive measure is to pre-set the device so that it cannot be turned up to damaging levels.
New Diabetes Screening Tool Promotes Early Detection in Adults
December 26, 2009
Nearly a third of those with diabetes don’t know they are ill. Now, researchers at Weill Cornell Medical College have developed a new screening tool aimed at improving early diagnosis in order to prevent or delay onset of the disease in adults. Details are published in the Dec. 1 Annals of Internal Medicine.
“Clinical trials show that high-risk individuals can reduce their risk of diabetes by more than half when they follow a well-structured, intensive, lifestyle modification program. Therefore, early diagnosis could be crucial,” says senior author Dr. Lisa Kern, assistant professor of public health and medicine. “However, existing recommendations for diabetes screening by blood testing are not widely followed, and 30 percent of diabetics still go undiagnosed.”
“Our goal was to develop an accurate and easy-to-use screening tool that can be used in a wide variety of community and clinical settings, including patient waiting rooms or online, or by using pencil and paper. The same questionnaire can be used for pre-diabetes as well as diabetes,” says lead author Dr. Heejung Bang, associate professor of biostatistics in public health. “By highlighting risk factors for diabetes, this tool is designed to motivate people to be screened, or at least to spark a discussion with their doctor and encourage them to adopt a healthier lifestyle.”
HIV ‘Prevention’ Gel PRO 2000 Proven Ineffective
December 26, 2009
This placebo-controlled trial, co-led by Imperial College London, involved 9,385 women at six research centres in four African countries and found that the risk of HIV infection in women who were supplied with PRO 2000 gel was not significantly different than in women supplied with placebo gel. Although ineffective in providing protection, PRO 2000 gel itself was safe to use.
A vaginal microbicide is a product intended for use before sexual intercourse to help reduce HIV infection, as it is clear that condom promotion alone has not controlled the epidemic. The gel was given to participants together with a package of prevention against HIV infection that included free condoms, counselling for safer sex negotiation and sexual health throughout the trial.
The trial, known as MDP 301, took place between September 2005 and September 2009 and was carried out by the Microbicides Development Programme (MDP), a not-for-profit partnership of 16 African and European research institutions. It was funded by the UK Department for International Development (DFID) and the UK Medical Research Council (MRC).
Study Redefines Placebo Effect As Part Of Effective Treatment
December 22, 2009
Researchers used the placebo effect to successfully treat psoriasis patients with one quarter to one half of their usual dose of a widely used steroid medication, according to an early study published online today in the journal Psychosomatic Medicine. Early results in human patients suggest that the new technique could improve treatment for several chronic diseases that involve mental state or the immune system, including asthma, multiple sclerosis and chronic pain.
By designing treatment regimens that mix active drug and placebo, researchers at the University of Rochester Medical Center hope to maximize drug benefits, reduce side effects, increase the number of patients who take their medicine and extend the use of drugs otherwise limited by addiction risk or toxicity. Using a fraction of the usual drug dose to get the same effect could also make possible a dramatic and timely reduction in healthcare costs, according to the authors.
The publication is a product of decades of research in the emerging field of “psychoneuro-immunology,” which holds that the ability of the human immune system to fight disease is closely linked with a person’s mind. Thoughts and moods are captured in neurochemicals that cause the release of hormones which interact with disease-fighting cells.
Pomegranates: The Latest Weapon In The Fight Against MRSA
December 22, 2009
Pomegranates have already been hailed as a super-food but a team of scientists from Kingston University in South West London has found a new use for the deep red fruit. The team, led by Professor Declan Naughton, has discovered that the rind can be turned into an ointment for treating MRSA and other common hospital infections.
In a series of tests conducted over three years, Professor Naughton and researchers from the School of Life Sciences learnt that the infection-fighting properties of pomegranate were greatly enhanced by combining the rind of the fruit with two other natural products – metal salts and Vitamin C. “We have developed a topical ointment that can successfully attack a range of drug resistant microbes,” Professor Naughton said. “It’s a significant breakthrough and a striking example of the effectiveness of adding more components to create a more active product.”
The tests were conducted using microbes such as MRSA (Methicillin-Resistant Staphylococcus aureus) taken from hospital patients. MRSA is an important pathogen – an agent of a disease - that can cause infections in humans and is difficult to combat because it has developed a resistance to some antibiotics. “The increase in drug-resistant infections found in hospitals has made our research topical and pressing,” Professor Naughton said. “The idea of using a foodstuff is unusual and means that the body should be able to cope more easily with its application; patients are less likely to experience any major side-effects.”
Steroid Injections May Slow Diabetes-Related Eye Disease
December 22, 2009
Researchers led by specialists at the Johns Hopkins Wilmer Eye Institute have found that injecting a corticosteroid, triamcinolone, directly into the eye may slow the progression of proliferative diabetic retinopathy, a complication of diabetes that frequently leads to blindness.
Authors of the study caution, however, that because use of steroids in the eye may increase the risk of glaucoma and cataract, laser photocoagulation remains the treatment of choice until further development of drugs that may reproduce the good effects of steroids, without the damage.
“Steroid treatment worked, but because of safety issues, cannot be recommended routinely at this time,” says Neil M. Bressler, the James P. Gills Professor of Ophthalmology and chief of the Retina Division of the Johns Hopkins Wilmer Eye Institute, chair of the government-sponsored Diabetic Retinopathy Clinical Research Network. “It is a condition that can be treated safely and effectively with lasers.”
Novel Nanotechnology Heals Abscesses Caused By Resistant Staph Bacteria
December 22, 2009
Abscesses are deep skin infections that often resist antibiotics and may require surgical drainage. For their new treatment strategy, the Einstein scientists developed tiny nanoparticles — smaller than a grain of pollen — that carry nitric oxide (NO), a gas that helps in the body’s natural immune response to infection.
When topically applied to abscesses in mice, the particles released NO that traveled deep into the skin, clearing up the infections and helping to heal tissue.
“Our work shows that nitric oxide-releasing nanoparticles developed here at Einstein can effectively treat experimental skin abscesses caused by antibiotic-resistant Staphylococcus aureus, even without surgical drainage,” says Joshua D. Nosanchuk, M.D., senior author of the study and associate professor of medicine and of microbiology & immunology.