IGIHE

Category: Health

  • How New Cancer Drugs Can skip Randomized Trials

    How New Cancer Drugs Can skip Randomized Trials

    In 2006 when doctors started testing a melanoma treatment made by Roche Holding AG on patients, they were used to facing slim odds – about one in eight – that the tumors would shrink on chemotherapy. This time, they couldn’t believe their eyes.

    With Zelboraf, a drug that targets specific mutations in cancer cells, eight out of 10 patients in an early-stage trial experienced significant tumor shrinkage. Roche clearly had a remarkable drug, though it only worked for people with a specific genetic makeup.

    Research like the Zelboraf tests, that fine-tune treatments to the genetic profile of patients, is fueling a rethink over how new cancer drugs are tested. The promise: medicines that, in theory at least, can win approval more easily and cheaply.

    That also raises ethical questions. If you know a certain treatment is genetically bound to work much better on some people than on others, is it right to conduct randomized trials to see which works best?

    Zelboraf led some doctors to question whether to go ahead with the trials they had planned, trials that would pit Zelboraf against the standard treatment, a chemotherapy developed in 1975 called dacarbazine.

    Some doctors believed that would risk patients’ lives unnecessarily. U.S. Food and Drug Administration cancer drug czar Dr. Richard Pazdur pushed for changes to shorten the trial.

    Others, such as Dr. Patrick Hwu of MD Anderson Cancer Center in Texas, refused to participate in a study that seemed bound to disadvantage some patients.

    Ultimately, the trial proceeded and the drug won U.S. approval in 2011. But experts say the controversy over Zelboraf broke the mould, potentially pointing the way to lower-cost drug development.

    At least one company has already indicated it will cut prices. Earlier this year, GlaxoSmithKline Plc won approval from the U.S. Food and Drug Administration for Tafinlar, a drug targeting the same mutant genes as Zelboraf, based on a single clinical trial of just 250 patients. It said the drug would cost $7,600 a month, 30 percent less than Zelboraf.

    Whether others follow suit in cutting prices will depend on a host of issues, perhaps the biggest of which is the vast difference in the way the United States and Europe regulate drugs.

    Pressure is mounting. A new and highly promising class of immunotherapy drugs – which some analysts see as a potential $35 billion a year market – may force companies’ hands.

    These therapies will come to market just as more people are asking if health insurers and governments will keep paying sky-high prices.

    Dr. Alexander Eggermont, chief executive of Institut Gustave-Roussy, France’s largest cancer center, was one of those who held a hard line on Zelboraf testing, insisting on a randomized trial.

    But Eggermont now says the standard of proof has changed and he believes immunotherapies – which he calls the “biggest game changer we have ever seen” – will cement the new approach to testing.

    “We won’t have to do those dinosaur trials,” he said. “It will change the whole attitude in drug development.”

    reuters

  • Kenya: Mysterious Disease Attacks 12 Pupils

    Kenya: Mysterious Disease Attacks 12 Pupils

    A strange disease has attacked 12 pupils of Lingisa Primary School in Kisumu County.

    The mysterious disease with symptoms of headache, hallucination and convulsion first struck last Friday leaving children in panic as parents contemplate withdrawing their children from the school.

    ‘‘On Friday, eight of our pupils were attacked by a strange disease and we took them for medication thinking that it was malaria.

    And on Monday, four more children were attacked,’’ said Charles Kaoko, the school’s Deputy Head teacher.

    standard

  • New Maternity Ward Commissioned at Muhima Hospital

    New Maternity Ward Commissioned at Muhima Hospital

    A new Matenity ward is slated to be established at Muhima Hospital, Nyarugenge District in patrnership between Kigali City and the Belgian Development Agency(BTC).

    The project expected to be completed in 4years is valued at Frw12Billion to be funded by BTC is part of a string of modern health facilities planned for Remera, Gatenga, Mageragere and Kanyinya in Kigali.

    The new facilities will be added to the existing wards to increase the capacity of the hospital to provide quality maternal and child care services in the hospital.

    The new ward at Muhima Hospital was commissioned September 6 by the Vice Mayor in charge of social affairs in Nyarugenge District, Pierre Kalisa, together with the director in charge of health and environment at City of Kigali, Blaise Uhagaze.

    He noted that there was a gap in health service delivery that prompted the Ministry of Health to ask for aid from development partners to address the challenge.

    The clinical director at the hospital, Placide Ntigurirwa said, “We receive 600-700 mothers a month but we didn’t have enough facilities to accommodate all of them. With this new maternity ward being commissioned, we will be able to attend to even more expectant mothers.”

    The maternity wing will be a two-storey building, with the ground floor used for cervical cancer screening, cancer registration, family planning, sterilising hospital equipment and some offices, while the upper floor will host labour rooms.

    Source: Newtimes

  • WHO: Life Expectancy Gap Growing Between Rich/Poor

    WHO: Life Expectancy Gap Growing Between Rich/Poor

    Life expectancy for women at 50 has improved, but the gap between poor and rich countries is growing and could worsen without better detection and treatment of cardiovascular disease and cancers, the World Health Organization (WHO) said on Monday.

    A WHO study, one of the first to analyse the causes of death of older women, found that in wealthier countries deaths from noncommunicable diseases has fallen dramatically in recent decades, especially from cancers of the stomach, colon, breast and cervix.

    Women over 50 in low and middle-income countries are also living longer, but chronic ailments, including diabetes, kill them at an earlier age than their counterparts, it said.

    “The gap in life expectancy between such women in rich and poor countries is growing,” said the WHO study, part of an issue of the WHO’s monthly bulletin devoted to women’s health.

    There is a similar growing gap between the life expectancy of men over 50 in rich and lower income countries and in some parts of the world, this gap is wider, WHO officials said.

    “More women can expect to live longer and not just survive child birth and childhood. But what we found is that improvement is much stronger in the rich world than in the poor world. The disparity between the two is increasing,” Dr. John Beard, director of WHO’s department of ageing and life course, said in an interview at WHO headquarters.

    Better Prevention and Treatment

    Beard, one of the study’s three authors, said: “What it also points to is that we need particularly in low and middle-income countries to start to think about how these emerging needs of women get addressed.

    The success in the rich world would suggest that is through better prevention and treatment of NCDs.”

    In women over 50 years old, noncommunicable diseases (NCDs), particularly cancers, heart disease and strokes, are the most common causes of death, regardless of the level of economic development of the country in which they live, the study said.

    Health ministers from WHO’s 194 member states agreed on a global action plan to prevent and control noncommunicable diseases at their annual ministerial meeting last May.

    Developed countries have tackled cardiovascular diseases and cancers in women with tangible results, the WHO study said.

    Fewer women aged 50 years and older in rich countries are dying from heart disease, stroke and diabetes than 30 years ago and these improvements contributed most to increasing women’s life expectancy at the age of 50, it said.

    An older woman in Germany can now expect to live to 84 and in Japan to 88 years, against 73 in South Africa and 80 in Mexico.

    “That reflects two things, better prevention, particularly clinical prevention around control of hypertension and screening of cervical cancer, but it also reflects better treatment,” Beard said.

    “I think that is particularly true for breast cancer where women with breast cancer are much better managed these days in the rich world. That also explains the disparity,” he said.

    Low-income countries, especially in Africa, offer community services to treat diseases like AIDS or offer maternal care but many lack services to detect or treat breast cancer, he said.

    In many developing countries, there is also limited access to high blood pressure medication to treat hypertension, one of the biggest risk factors for death, he added.

    Women with cardiovascular disease and cancers need the kind of chronic treatment provided to those with HIV/AIDS, he said.

    agencies

  • Kenyan Doctor Warns on Fresh Aids Cure Claims

    Kenyan Doctor Warns on Fresh Aids Cure Claims

    A leading researcher Wednesday issued an alert over claims that an anti-cancer drug has proven to be an effective Aids cure.

    Dr Patrick Orege of the Kenya Medical Research Institute in Kisumu urged the public to remain cautious, warning that there was no cure for Aids yet.

    Two patients were purportedly cured of Aids after being treated by Dr Barasa Situma, who administered methotrexate — an anti-cancer treatment drug — and a cocktail of other drugs in Nairobi.

    “The purported cure on the two patients is referred to as a ‘chance-finding’ and an interesting observation which is however not (beneficial to the public) since it involves only two patients.

    dndrbaraza.jpg
    Photo: Dr Simon Barasa Situma of the Kenya Polytechnic University College.

    “In any case, we don’t know the number of other patients who were administered with the drugs and failed,” Dr Orege said.

    During a previous media interview, Dr Situma claimed the HIV patients had turned negative after being tested at three laboratories — Cresent Medical Aid Kenya, Lancet Lab and Kemri in Nairobi.

    “The public should not be duped into using the drug which is a known treatment for cancer and not HIV,” Dr Orege, who is also a former director of the National Aids Control Council said.

    At the same time, he dismissed the decision by Dr Situma to use the services of three laboratories in determining the HIV results of the patients as “inconsistent with research methodology”.

    “To achieve consistent results, Dr Situma should have utilised one laboratory and enrolled between 200 to 300 patients in his trials instead of being enthusiastic in announcing the results involving two patients,” he said.

    Dr Orege continued: “I would like to advise Dr Situma to develop a proposal on the treatment and get in touch with medical scientists at either the University of Nairobi’s Kenyatta National Hospital or Kenya Medical Research Institute.”

    He warned that methotrexate was known to have adverse effects in the treatment of cancer and should be administered with “a lot of care”.

  • Kyrgyzstan boy dies of bubonic plague

    Doctors in Kyrgyzstan have said a teenage boy has died of bubonic plague, but that an epidemic is not likely.

    The death of the 15-year-old herder was confirmed on Monday, several days after his death in the Karakol regional hospital.

    Health ministers said the boy, from the small mountain village Ichke-Zhergez in eastern Kyrgyzstan, died last Thursday after being diagnosed with bubonic plague, which is carried by rodents and caused millions of deaths throughout Europe in the 14th century.

    “After a meeting of doctors, he was diagnosed with bubonic plague,” a statement said.

    His body was cremated and remains were buried with special precautions.

    “We suspect that the patient was infected with the plague through the bite of a flea,” Tolo Isakov, a ministry official who heads the sanitation department, said in Bishkek on Monday.

    The oriental rat flea carries the bubonic plague after biting an infected rodent and may then pass the disease to a human.

    Officials have dispatched two teams to the area to “catch, exterminate, and study rodents,” Isakov said.

    He said the last recorded case of bubonic plague occurred in Kyrgyzstan 30 years ago.

    wirestory

  • Scientists: Bats are Source of Saudi Arabia’s Deadly Virus

    The source of a new virus that has killed 39 people in Saudi Arabia has been discovered as hundreds of local Muslims prepare to visit Mecca for Hajj.

    While the Saudi government has not placed travel restrictions on those wishing to make the annual pilgrimage, it has advised people aged over 65, children under 12, pregnant women and those with chronic diseases to postpone their plans for Hajj this year because of fears of the new virus.

    Kenya Airways has indicated it will be offering additional flights for the October – November Hajj period to meet an expected high demand. The airline will increase the number of flights to Jeddah from the current two per week to four.

    Since the emergence of the so-called ‘coronavirus’ last year, which is causing the disease, Middle East Respiratory Syndrome or MERS, teams of medical detectives from all over the world have been combing the Middle East for it.

    Of the 47 deaths so far caused by the disease, 39 have been in Saudi Arabia indicating this to be the possible ground zero. A total of 96 cases have been recorded so far in eight countries.

    On Wednesday, researchers from Columbia University, US, said they have pinpointed the source of the virus as the insect-eating bat called Egyptian Tomb Bat, somewhere close to the first known case of the disease in Saudi Arabia.

    Genetic match

    Although there were earlier reports that the virus had been detected in domestic camels in Saudi Arabia, this according to the researchers is the first time the find has been a 100 per cent genetic match.

    “There have been several reports of finding MERS-like viruses in animals. None were a genetic match. In this case, we have a virus in an animal that is identical in sequence to the virus found in the first human case.

    Importantly, it’s coming from the vicinity of that first case,” Dr Ian Lipkin, one of the researchers said in a statement from the university.

    Last month, a team set up by the World Health Organisation (WHO) to keep an eye on the MERS virus advised that the disease has not reached pandemic potential and hence there was no need for the world to panic or issue travel restrictions.

    However, the global health body has advised its members to be on the lookout for the new virus and wants all doctors to be especially vigilant with patients with severe respiratory infections and to carefully review any unusual patterns.

    agencies

  • Cocaine ‘Rapidly Changes the Brain’

    Taking cocaine can change the structure of the brain within hours in what could be the first steps of drug addiction, according to US researchers.

    Animal tests, reported in the journal Nature Neuroscience, showed new structures linked to learning and memory began to grow soon after the drug was taken.

    Mice with the most brain changes showed a greater preference for cocaine.

    Experts described it as the brain “learning addiction”.

    The team at University of California, Berkeley and UC San Francisco looked for tiny protrusions from brain cells called dendritic spines. They are heavily implicated in memory formation.

    Cocaine hunting

    The place or environment that drugs are taken plays an important role in addiction.

    In the experiments, the mice were allowed to explore freely two very different chambers – each with a different smell and surface texture.

    Once they had picked a favourite they were injected with cocaine in the other chamber.

    A type of laser microscopy was used to look inside the brains of living mice to hunt for the dendritic spines.

    More new spines were produced when the mice were injected with cocaine than with water, suggesting new memories being formed around drug use.

    The difference could be detected two hours after the first dose.

    Researcher Linda Wilbrecht, assistant professor of psychology and neuroscience at UC Berkeley, said: “Our images provide clear evidence that cocaine induces rapid gains in new spines, and the more spines the mice gain, the more they show they learned about the drug.

    “This gives us a possible mechanism for how drug use fuels further drug-seeking behaviour.

    “These drug-induced changes in the brain may explain how drug-related cues come to dominate decision making in a human drug user.”

    4-3.jpg

  • Fast Moving Snails Spread Deadly Dog Disease

    Despite their lethargic reputations, snails can travel at a relatively speedy one metre per hour, say researchers.

    By attaching multicoloured LED lights, the scientists were able to track their movements over a 24-hour period.

    The gastropods were fast enough to explore the length of an average UK garden in a single night.

    But scientists are worried that the fast-moving snails are spreading a parasite that is deadly for dogs.

    Over the past few years the wet summers enjoyed across the UK have proved the ideal breeding grounds for snails.

    According to the Royal Horticultural Society, their numbers increased by 50% last year.

    As well as being a pest for gardeners, snails can also spread a parasite called Angiostrongylus vasorum.

    This lungworm is a particular threat to dogs, which can become infected by accidentally eating slugs or snails which they come across in the garden or on dog toys.

    Painted snails

    Researchers at the University of Exeter were commissioned to look into the scale of the threat by the Be Lungworm Aware campaign, which was set up and funded by Bayer Animal Health.

    The scientists attempted to track the movements of snails in garden situations.

    To do this they attached tiny, multicoloured LED lights to the backs of about 450 snails and used UV paint to track their movements.

    The researchers found that the snails could cover distances up to 25m in a 24-hour period.

    “They are so slow that people don’t even think about them moving, but it turns out they do, and they can go a long way in a night,” said Dr Dave Hodgson, who led this study and was also involved in a BBC amateur science experiment in 2010 that sought to discover if snails had a homing instinct.

    The researchers say their new work indicates that snails pose a growing threat to pets.

    “They are not just lettuce munchers, they are carriers of parasites that can kill your dogs,” said Dr Hodgson,

    A recent survey of veterinary surgeons indicated that the lungworm parasite was now endemic across the UK, where once it was mainly found in the south.

    “It is becoming a real problem not just in the south of England, it is moving north to Scotland,” said Dr Hodgson.

    “It is a national problem and we all have to pay attention to the interactions between dogs and snails,” he said.

    Happy trails

    In the new work, the scientists were surprised to see so many snails followed the slimy trails laid by others. Dr Hodgson says it is all about conserving energy.

    “We know that snails use about 40% of their energy budget producing slime.

    “Given a chance, a snail will prefer to follow a trail that has been laid by another, it is a form of cheating like slipstreaming,” he said.

    As to what pet owners should do, the scientists suggested they should regularly check the nooks and crannies in their gardens for snails and try to reduce exposure to the species.

    “I wouldn’t be too happy suggesting that there should be a snail apocalypse and everyone should get rid of them,” said Dr Hodgson.

    “I think awareness is a better idea, people need to understand the wildlife in their gardens and that no organism is totally harmless.”

    source:BBC

  • Counterfeit Medicine Trade Targets Africa’s Poor

    From Cameroon to Ivory Coast, Kenya to the DR Congo, traders in counterfeit drugs do a thriving business with the utmost cynicism and sometimes at the cost of human lives.

    “Street medication kills. The street is killing (safe) medication,” declares a banner outside a pharmacy in the Cameroonian capital Yaounde, where the dangerous trade is rampant.

    The market is saturated with counterfeit anti-malaria drugs, painkillers, antibiotics and even rehydration serum. No domain of the pharmaceutical industry is spared by illicit manufacturers and traffickers, according to media reports.

    “That’s powerful Diclofenac (an anti-inflammatory), which is the bestseller,” says Blaise Djomo, a street vendor at Yaounde’s central market. “And this is Viagra, which Cameroonians are really wild about.”

    About 100 traders like Djomo are set up under parasols in full view of everyone, their boxes heaped with medicines. Bubble-pack strips of pills are lined up in the wooden stalls.

    People can even buy single pills at this market or even at some grocery stores. Vendors often mix fake medication with the real thing, which has either been legally acquired or stolen from supplies meant for hospitals and clinics.

    At best, fake prescription drugs have no effect, acting like placebos, but at their worst, they are highly toxic. Either way they bring in vast sums of money for those behind the illicit traffic.

    The UN Office on Drugs and Crime (UNODC) warned at a conference last February that counterfeit drugs are a multi-billion dollar business accounting for 30 percent of the pharmaceutical market in parts of Africa.

    “Fraudulent medicines have proven to be harmful and at times fatal, as well as an increasingly lucrative area for organised criminal networks,” the agency said in a press release.

    “The supply routes are of two kinds. Alongside the small-scale smugglers, there are international criminal networks that undertake the supply of drugs from distant manufacturers in China and India,” said Parfait Kouassi, who chaired the National Order of Pharmacists in Ivory Coast from 2005 to 2012.

    Kouassi, who made a priority of fighting the dangerous trade in fake medicines, escaped two murder bids at the headquarters of the Order of Pharmacists. “That’s a sign that major interests are in play and that it’s not just a matter of small-scale local traffickers,” he said.

    The phenomenon is spreading and represents between 20 and 25% of the drug market in Ivory Coast, adds Kouassi.

    In Kenya, 30% of drugs sold in 2012 were either fake or counterfeit, according to the Pharmacy and Poisons Board of Kenya. Cameroon health officials give a similar figure.

    However, in the Democratic Republic of Congo, as in many other African countries, there are no national statistics, just records of frequent drugs seizures.

    In Nigeria — once known as a major source of counterfeit medicines — phony drugs and real ones that had passed their expiry date made up 70% of sales in 2002, according to the World Health Organisation.

    Since then, in the continent’s biggest market with some 160 million people, officials say that high-profile efforts have greatly reduced the number of fake or adulterated drugs, but reliable figures are hard to obtain.

    “Most of these fake and adulterated drugs come from China and India, from where we import more than 50 percent of the drugs we use in Nigeria. We don’t import much drugs from the US,” says Abubakar Jimoh, spokesman of the National Agency for Food and Drug Administration and Control (NAFDAC).

    “They no longer bring … illicit drugs in large containers but in small packs. They also change the labels of the drugs from outside the country to make them look original,” Jimoh said.

    Health authorities have set up a service to enable consumers to check the authenticity of drugs by verifying the PIN serial number on the product label via an SMS message.

    Safe vs. cheap: the cost factor

    The outstanding exception on the continent in fighting the illicit drug trade is South Africa, which has a strictly enforced licencing system, according to Griffith Molewa, head of law enforcement at the Medicines Control Council.

    “We have dedicated ports of entry for medicines, restricted to Durban, Cape Town, Port Elizabeth and OR Tambo airport in Johannesburg,” Molewa said. “We also have a vertically integrated system, meaning only manufacturers can sell to the wholesalers, and then the wholesaler to the retail outlets, and then the pharmacies can only serve the patients.”

    “Any product found on the street is seized and given to the police for prosecution. The penalty is a fine or up to 10 years of imprisonment or both.”

    In most other countries, measures against the counterfeit drug trade are limited to police raids on public markets to seize fake or adulterated products, along with public information and awareness campaigns, which appear to have little effect on consumers.

    For in countries where medical expenses — from drugs to hospitalisation — are not even partly reimbursed by the state, the relatively cheap price of street medication trumps the risk factor for many.

    “I’m here to buy a worm treatment and something to protect my children from malaria,” customer Nadine Mefo told media at Yaounde’s central market. “It costs less than in the pharmacy and it soothes the children.

    “Doctors say that street market medicines are dangerous, but since I’ve been coming, I’ve not yet had a problem,” she adds, clutching two packs of pills of unknown origin.

    AFP