IGIHE

Category: Health

  • Suspected cases of Ebola rise to 29 in Democratic Republic of Congo

    {The number of suspected cases of Ebola has risen to 29 from nine in less than a week in an isolated part of Democratic Republic of Congo, where three people have died from the disease since April 22, the World Health Organization said on Thursday.}

    The W.H.O. was criticized for responding too slowly to an outbreak in West Africa in 2014 that left more than 11,000 people dead, and Dr. Peter Salama, the executive director of the organization’s health emergencies program, said at a briefing that it was essential to “never, ever underestimate Ebola” and to “make sure we have a no-regrets approach to this outbreak.”

    The risk from the outbreak is “high at the national level,” the W.H.O. said, because the disease was so severe and was spreading in a remote area in northeastern Congo with “suboptimal surveillance” and limited access to health care.

    “Risk at the regional level is moderate due to the proximity of international borders and the recent influx of refugees from Central African Republic,” the organization said, but it nonetheless described the global risk as low because the area is so remote.

    About a week ago, in addition to the nine suspected cases, 125 patients who had come into close contact with the disease were being monitored. Now about 400 patients are being followed, even as nine new cases were reported on Thursday, according to the W.H.O.

    The Ebola virus causes fever, bleeding, vomiting and diarrhea, and it spreads easily by contact with bodily fluids. The death rate is high, often surpassing 50 percent, particularly with the Zaire strain, which has been confirmed in two cases in this outbreak.

    The outbreak was reported in a densely forested part of Bas-Uele Province, near the border with the Central African Republic. Cases have occurred in four separate parts of a region called the Likati health zone.

    Aid groups and the W.H.O. have struggled to reach the affected area, which has no paved roads and can be reached only by a motorcycle ride through the forest, or by helicopter or light aircraft.

    The first known case occurred on April 22, when a 39-year-old man who had fever, vomiting, diarrhea and bleeding died on the way to a hospital in the Likati zone. The person caring for him and a motorcyclist who transported him also died.

    The first six months of the response to the outbreak are expected to cost the W.H.O. and aid groups $10 million, Dr. Salama said at the briefing. He said telecommunications networks would have to be established and airstrips repaired so that aid workers can provide the necessary medical care.

    The W.H.O., aid groups and the Congolese government are discussing the possibility of using an experimental Ebola vaccine, made by the American pharmaceutical company Merck, that proved effective in Guinea.

    The response would involve a “ring vaccination,” in which contacts of patients, contacts of contacts, and health workers would be vaccinated. There would be no mass public vaccination.

    The vaccine has not yet been licensed, and its use would require permission on several fronts. Nonetheless, Dr. Salama said that if permission were granted, the vaccine could be made available in a week or so. Other experimental antiviral drugs may also be considered.

    The Ebola virus is considered endemic in the Democratic Republic of Congo, where eight outbreaks, the largest involving about 300 patients, have been recorded since 1976.

    The country “has considerable experience and capacity in confronting these outbreaks,” Dr. Daniel Bausch, an Ebola expert at the W.H.O., said in an email. He added, “I think there is a very good probability that control can be rapidly achieved.”

    Dr. Salama said that aid workers had reached a town in the Likati zone, which was as close as they had been able to come to the epicenter of the outbreak. He said aid groups were setting up centers for treatment and isolation, and mobile labs.

    The first aid group to arrive was the Alliance for International Medical Action, which was already in the region, responding to cholera.

    In a telephone interview from Conakry, Guinea, the group’s executive director, Matthew Cleary, said that seven people who were believed to have contracted Ebola had been taken to a district hospital in the Likati zone that was not equipped to deal with the virus.

    “It’s urgent to get them into a proper isolation center,” Mr. Cleary said, adding that the group is preparing to build a treatment unit. It will include windows that allow families to see patients, a response to past outbreaks in which people feared and sometimes shunned sealed-up isolation units into which patients seemed to disappear.

    Brienne Prusak, a spokeswoman for Doctors Without Borders said on Wednesday that the group had sent a team of about 20 doctors, nurses and other experts to the Likati zone, and that it was still trying to figure out how to reach the epicenter.

    “Transport is extremely difficult in the area, and helicopter flights may be the only way to get there,” she said by email. “We considered motorbikes but are now thinking of helicopters because we need to get so many materials there. We’re expecting to get to the epicenter by the weekend.”

    The Centers for Disease Control and Prevention in the United States is also sending a renowned Ebola expert, Dr. Pierre Rollin, to Congo, along with epidemiologists, a spokeswoman said.

    Medical workers treating a patient suspected of having Ebola in the Democratic Republic of Congo in 2007.

    Source:The New York Times

  • Cardiovascular disease causes one-third of deaths worldwide

    {‘Alarming trends’ for countries in all stages of development}

    Cardiovascular diseases (CVD), including heart diseases and stroke, account for one-third of deaths throughout the world, according to a new scientific study that examined every country over the past 25 years.

    Countries with the greatest number of cardiovascular deaths, after accounting for population size, are found throughout Eastern Europe, Central Asia, the Middle East, South America, sub-Saharan Africa, and Oceania. Additionally, the steep declines experienced by the United States, Canada, Australia, New Zealand, Japan, South Korea, and countries in Western Europe over the past two decades have begun to taper off and plateau.

    “It is an alarming threat to global health,” said Dr. Gregory Roth, Assistant Professor at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington and in the Division of Cardiology at the University of Washington School of Medicine. “Trends in CVD mortality are no longer declining for high-income regions and low- and middle-income countries are also seeing more CVD-related deaths.”

    Dr. Roth is the lead author of the paper, “Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990-2015,” which was published in the Journal of the American College of Cardiology.

    In 2015, there were more than 400 million individuals living with CVD and nearly 18 million CVD deaths worldwide. From 1990 to 2010, the age-standardized death rate from CVD dropped globally, driven by improvements in high-income countries, but that progress has slowed over the last five years. In 1990, there were about 393 deaths for every 100,000 people from CVD globally. That fell to 307 deaths per 100,000 in 2010, and, over the next five years, decreased only slightly, to 286 deaths per 100,000.

    “This paper is the manifestation of two paradoxes,” said JACC Editor-in-Chief Valentin Fuster, MD, PhD. “First, we keep discussing how much we have progressed among our subspecialty, yet the paradox is that the disease state remains the number 1 killer in the world. The second paradox is that medicine remains very expensive, yet we don’t put efforts into promoting health at younger ages, which could be a cost-effective method to preventing the onset of the disease. Instead, we continue to only invest in treating advanced manifestations of cardiovascular disease.”

    The paper is based on the most recent Global Burden of Disease (GBD) study, an international consortium of more than 2,300 researchers in 133 nations, convened by IHME.

    Dr. Paulo Lotufo with the University of São Paulo in Brazil, one of the paper’s co-authors, noted: “High levels of cardiovascular disease can be especially problematic for low-resource countries with limited access to or availability of effective treatments. Many nations are now dealing with a ‘double burden’ of chronic and infectious disease, which puts additional strain on health systems.”

    Prevalence rates of CVD, including coronary artery disease, atrial fibrillation, heart failure, stroke, and peripheral arterial disease, were highest across sub-Saharan Africa, Eastern and Central Europe, and Central Asia. Some of the lowest rates occurred in high-income Asian countries such as Singapore, Japan, and South Korea, and southern South American countries, including Chile and Argentina.

    The highest CVD death rates occurred throughout Central Asia and Eastern Europe, but also in countries such as Iraq, Afghanistan, and many South Pacific island nations. The lowest rates were in Japan, Andorra, Peru, France, Israel, and Spain.

    Using a measure of development status that combines levels of education, fertility, and income — the Socio-demographic Index (SDI) — Dr. Roth and other researchers discovered that, on average, CVD mortality first increased, then declined steeply with increasing SDI, only to plateau in the last few years.

    “High levels of cardiovascular disease are seen throughout the world, both in high-income countries and those with more limited access to effective and inexpensive treatments,” Dr. Roth said. “Risk factors for CVD, like high blood pressure, poor diet, high cholesterol, tobacco smoking, excessive alcohol use, and obesity, are common throughout most of the world.”

    He noted that the study’s findings present opportunities for public health officials on the local, national, and international levels to share successful strategies for addressing these risk factors.

    “The population health community realizes that CVD is a global problem,” he said. “Now we need to find innovative ways to deliver our low-cost, effective treatments to the hundreds of millions of people who can’t access them.”

    Of the cardiovascular conditions studied, ischemic heart disease, also known as coronary artery or heart artery disease, was the leading cause of health loss in every region of the world except sub-Saharan Africa. In 2015, there were an estimated 7.3 million heart attacks and 110.6 million people living with heart artery disease.

    The highest prevalence rates for heart artery disease were found in Eastern Europe, followed by Central Asia and Central Europe, but high rates were also found in some parts of sub-Saharan Africa, the Middle East/North Africa region, and South Asia. Peripheral artery disease was the most prevalent CVD cardiovascular disease worldwide, even though much of it is estimated to be without symptoms.

    Stroke was the second-leading cause of global health loss. In 2015, there were nearly 9 million first-time strokes. Prevalence rate of heart artery disease and stroke began increasing as early as age 40, showing that these are not only diseases of the elderly, but also impact younger individuals who are working or caring for family.

    Other cardiovascular conditions examined include hypertensive heart disease, cardiomyopathy, aortic aneurysm, atrial fibrillation, and rheumatic heart disease.

    “Past periods of decline in cardiovascular disease mortality marked a remarkable achievement for public health and medical care around the world,” said Dr. Christopher Murray, director of IHME and study co-author. “Governments, advocacy groups, clinicians, and communities should look to this new evidence when developing programs and policies that could reduce the burden of cardiovascular disease and save more lives.”

    Cardiovascular diseases, including heart diseases and stroke, account for one-third of deaths throughout the world.

    Source:Science Daily

  • Natural resistance to malaria linked to variation in human red blood cell receptors

    {First study to identify protective effect of glycophorin gene rearrangements on malaria}

    Researchers have discovered that protection from the most severe form of malaria is linked with natural variation in human red blood cell genes. A study from the Wellcome Trust Sanger Institute, the Wellcome Trust Centre for Human Genetics and their collaborators has identified a genetic rearrangement of red blood cell glycophorin receptors that confers a 40 per cent reduced risk from severe malaria.

    Published in Science, this is the first study to show that large structural variants in human glycophorin genes, which are unusually common in Africa, are protective against malarial disease. It opens a new avenue for research on vaccines to prevent malaria parasites invading red blood cells.

    More than 200 million people a year are infected with malaria and the disease caused the deaths of nearly half a million people worldwide in 2015. Transmitted by mosquitoes, the most widespread malarial parasite in Africa is Plasmodium falciparum; it is also the most dangerous.

    Plasmodium parasites infect human red blood cells and gain entry via receptors on the cell surface. Previous studies on natural resistance to malaria had implicated a section of human genome near to a cluster of receptor genes. These receptors — glycophorins — are located on the surface of red blood cells and are amongst many receptors that bind Plasmodium falciparum. However, it is only now that they have been shown to be involved in protection against malaria.

    Researchers investigated the glycophorin area of the genome in more detail than before using new whole-genome sequence data from 765 volunteers in the Gambia, Burkina Faso, Cameroon and Tanzania. Using this new information they then undertook a study across the Gambia, Kenya and Malawi that included 5310 individuals from the normal population and 4579 people who were hospitalised from severe malaria. They discovered that people who have a particular rearrangement of the glycophorin genes had a 40 per cent reduced risk of severe malaria.

    Dr Ellen Leffler from the University of Oxford, first author on the paper, said. “In this new study we found strong evidence that variation in the glycophorin gene cluster influences malaria susceptibility. We found some people have a complex rearrangement of GYPA and GYPB genes, forming a hybrid glycophorin, and these people are less likely to develop severe complications of the disease.”

    The hybrid GYPB-A gene is found in a particular rare blood group — part of the MNS* blood group system — where it is known as Dantu. The study found that the GYPB-A Dantu hybrid was present in some people from East Africa, in Kenya, Tanzania and Malawi, but that it was not present in volunteers from West African populations.

    Dr Kirk Rockett from the University of Oxford, said: “Analysing the DNA sequences allowed us to identify the location of the join between glycophorins A and B in the hybrid gene. It showed us that the sequence is characteristic of the Dantu antigen in the MNS blood group system.”

    Studying the glycophorin gene cluster to determine differences between the sequences of the three genes with confidence is extremely challenging. This study gives insights into unpicking the region and how it connects to the MNS blood group system and impacts malaria susceptibility.

    Professor Dominic Kwiatkowski, a lead author from the Wellcome Trust Sanger Institute and University of Oxford, said: “We are starting to find that the glycophorin region of the genome has an important role in protecting people against malaria. Our discovery that a specific variant of glycophorin invasion receptors can give substantial protection against severe malaria will hopefully inspire further research on exactly how Plasmodium falciparum invade red blood cells. This could also help us discover novel parasite weaknesses that could be exploited in future interventions against this deadly disease.”

    *The MNS system is a human blood group system based on two genes — glycophorin A and glycophorin B — on chromosome 4. There are 46 antigens in the system; the most common are called M, N, S, s and U.

    A new study shows that large structural variants in human glycophorin genes, which are unusually common in Africa, are protective against malarial disease.

    Source:Science Daily

  • Migrant children less obese due to absent grandmothers

    {Children of migrants to Chinese cities have lower rates of obesity than youngsters in more affluent established urban families — probably because their grandparents are not around to over-feed them, a new study has found.}

    Fewer opportunities for unhealthy snacking and less pressure for academic achievement, leading to more active play, also contribute to migrant children’s lower obesity rates.

    Large-scale migration sees millions of Chinese families leave the countryside and settle in the country’s biggest cities in search of economic prosperity.

    However, migrant children are still at risk of increasing obesity because, unlike youngsters from affluent families, lack of parental supervision after school and unsafe neighbourhoods cause them to eat unhealthily and limit opportunities for active play.

    Researchers at the University of Birmingham interviewed parents, grandparents and teachers at schools in the city of Guangzhou, in southern China. Their study — published today in the journal PLOS ONE — explored the differences in perceived causes of childhood obesity between local and migrant communities.

    They worked in partnership with the Guangzhou Centre for Disease Control and the Guangzhou Health Care Promotion Centre for Primary and Middle Schools to carry out the first qualitative study to explore and identify these differences in urban China.

    Dr Bai Li, from the University of Birmingham, said: “Childhood obesity is a global public health crisis — particularly in China, yet the health of children who migrate with their parents to major Chinese cities has rarely been explored.

    “It is clear that an important step towards preventing the rise of obesity in migrant children is understanding the perceptions of parents, grandparents and teachers on the causes of childhood obesity.”

    She added that 15 per cent of Chinese children and adolescents, aged 7-18, are overweight or obese — accounting for 30.43 million individuals. Live-in grandparents in local families often took responsibility for looking after their grandchild, but many viewed a fat child as a symbol of health and success and, as a result, overfed them.

    However, grandparents of migrant children remained living in their hometown and had no influence on childcare.

    Migrant children had fewer opportunities for unhealthy snacking after school, because they had to catch buses home — getting on and off the vehicles within their school. Yet, local children often bought food from unlicenced street traders or were met at the school gates by their grandmothers bearing snacks.

    “Although childhood obesity in major Chinese cities is currently more prevalent among local children than migrant children, recent trends suggest a steeper increase among youngsters coming to the cities from rural areas,” commented Dr Li.

    “The results of our study highlight the need for tailored interventions to prevent a significant rise in the number of migrant children who are overweight or obese and the associated short and longer term health consequences.

    “Future interventions for local communities should include education for grandparents, enforcement of regulations limiting illegal food traders outside schools and education policies that re-balance academic focus with increased physical activity. Within migrant communities on the other hand, interventions should focus on supporting parents and providing more physical activity opportunities outside of school.”

    Earlier research by Birmingham and Guangzhou researchers showed that the prevalence of obesity in resident children in Guangzhou was 20% compared with 14.3% in migrant children. Migrants now comprise up to 50% of the population in major cities across China. In general, they tend to have lower levels of income and education than city residents.

    The earlier study found that the obesity among resident urban children was higher in boys than compared with girls. It also increased as children grew older and per-capita household income and maternal education increased.

    Dr Weijia Liu said: “Childhood obesity is an important public health problem in China. With the cooperation of the University of Birmingham, the Guangzhou Center for Disease Control is able to deepen the research of factors contributing to childhood obesity in China.

    “Our research does not only provide a scientific basis for formulating effective intervention for childhood obesity in the city, but also strengthens the friendship and cooperation between the two cities.”

    Children of migrants are said to have lower rates of obesity than youngsters in more affluent established urban families -- probably because their grandparents are not around to over-feed them, a new study has found.

    Source:Science Daily

  • New research reveals how exercising can make ten years younger

    {There’s no therapy, diet or cream that can stop the effect of ageing; ageing is a natural process that has been, from the beginning of time.}

    However, the effects of ageing can be slowed down, as we can see that some people tend to age faster than some people. Besides genetics, ageing can also be slowed down, various researches has found.

    A new research reveals you may be able to slow one type of aging – the kind that happens inside your cells – if only you’re willing to sweat.

    The study which was conducted by researchers from Brigham Young University finds that people who have consistently high levels of physical activity have significantly longer telomeres than those who have sedentary lifestyles, as well as those who are moderately active.

    Telomeres are the protein endcaps of our chromosomes. They’re like our biological clock and they’re extremely correlated with age; each time a cell replicates, we lose a tiny bit of the endcaps. Therefore, the older we get, the shorter our telomeres.

    Exercise science professor Larry Tucker found adults with high physical activity levels have telomeres with a biological aging advantage of nine years over those who are sedentary, and a seven-year advantage compared to those who are moderately active. To be highly active, women had to engage in 30 minutes of jogging per day (40 minutes for men), five days a week.

    “Just because you’re 40, doesn’t mean you’re 40 years old biologically,” Tucker said. “We all know people that seem younger than their actual age. The more physically active we are, the less biological aging takes place in our bodies.”

    “If you want to see a real difference in slowing your biological aging, it appears that a little exercise won’t cut it,” Tucker added. “You have to work out regularly at high levels.”

    The study was published in the medical journal Preventive Medicine.

    Source:Elcrema

  • WHO prepares experimental Ebola vaccine for possible first use in Democratic Republic of Congo

    {The World Health Organization and outside experts are making arrangements to send an experimental Ebola vaccine to the Democratic Republic of Congo, should officials there say they need it to quell an outbreak there.}

    The DRC has not yet formally requested the vaccine, and it’s unclear if or when it will. The country’s drug regulatory agency would also have to authorize emergency use of the vaccine, which is not yet licensed.

    But the WHO and Gavi, the Vaccine Alliance, told STAT that preparations to have the experimental vaccine ready for use are being made on a parallel track with investigations in DRC into the scale of the outbreak.

    “If the question is: Is it going to be used in this particular outbreak? It’s not clear yet,” said Dr. Seth Berkley, CEO of Gavi, a public-private partnership that provides vaccines to lower income countries.

    “That being said, everything is being put in place to use the vaccine if it is requested or if it turns out the need accelerates.”

    The outbreak, reported to the WHO last week, has grown to 20 suspected cases. Three of the infected have died.

    This Ebola epidemic, the country’s eighth, is in a remote part of northern DCR, a province called Bas-Uele. It is a part of the country with few roads, which should help contain the epidemic. The three previous Ebola outbreaks in DRC involved dozens of cases as opposed to hundreds or thousands.

    But the location also creates logistical difficulties. Transporting medical supplies and teams of investigators to the outbreak zone is slow work — as is getting patient samples back to the capital, Kinshasa, for testing.

    It will also be challenging to get doses of vaccine to the area if the government decides to use it. The experimental Ebola vaccine must be stored at -80 Celsius, which would involve transporting it in freezers.

    The vaccine, which goes by the working name rVSV-ZEBOV, is being developed by pharmaceutical giant Merck. Although there are other experimental Ebola vaccines at various stages of development, this is the only one so far which has been shown to protect people from the deadly virus.

    That evidence comes from a clinical trial conducted in Guinea during the West African Ebola outbreak of 2014-2015. The trial showed the vaccine induced quick protection, a desirable characteristic for a vaccine designed for use in controlling outbreaks.

    That study used what is known as a ring vaccination design, in which people who had been in contact with a confirmed case were vaccinated to prevent ongoing spread. The WHO has said if DRC uses the Ebola vaccine, it should vaccinate using the ring technique, said Tarik Jašarević, a spokesman for the WHO.

    In an agreement with Gavi, Merck is required to have on hand at all times at least 300,000 doses of the Ebola vaccine. There is also currently a small number of doses — around 800 or 1,000 — in Geneva, Berkley said.

    A spokeswoman for Merck said the company is in contact with WHO, Doctors without Borders — which has sent a response team to the outbreak site — and other organizations about the outbreak.

    “We stand ready to ship our investigational vaccine for Ebola Zaire … once appropriate approvals are in place,” she said in an email.

    Berkley pointed out that because the vaccine has not yet been licensed, there are regulatory hurdles to clear before it can be used, and that can take some time.

    “It’s a little different than yellow fever vaccine, which can be stored in different places and used as a clinical vaccine pretty indiscriminately. There are some complexities with using this,” Berkley said.

    So will this outbreak be the first in history where Ebola vaccine is used to help stamp out transmission? It’s too soon to say, he said.

    “To be honest with you, I would hope that the epidemic would be over so quickly and there would be so few deaths that there would be no need to use it,” Berkley said.

    “That’s the best-case scenario for everybody,” he said. “Of course, if the outbreak goes further or there’s an opportunity to use it, I would like to make sure we don’t have another large outbreak and that it does get used.”

    A Liberian pharmacist prepares an Ebola vaccine.

    Source:Stat

  • Popular weight-loss surgery puts patients at high risk for alcohol problems

    {One in five patients who undergo one of the most popular weight-loss surgical procedures is likely to develop problems with alcohol, with symptoms sometimes not appearing until years after their surgery, according to one of the largest, longest-running studies of adults who got weight-loss surgery.}

    The finding — reported online today in Surgery for Obesity and Related Diseases, the journal of the American Society for Metabolic and Bariatric Surgery — indicates that bariatric surgery patients should receive long-term clinical follow-up to monitor for and treat alcohol use disorder, which includes alcohol abuse and dependence.

    “We knew there was an increase in the number of people experiencing problems with alcohol within the first two years of surgery, but we didn’t expect the number of affected patients to continue to grow throughout seven years of follow-up,” said lead author Wendy C. King, Ph.D., associate professor of epidemiology at the University of Pittsburgh Graduate School of Public Health. She and her team discovered that 20.8 percent of participants developed symptoms of alcohol use disorder within five years of Roux-en-Y gastric bypass (RYGB). In contrast, only 11.3 percent of patients who underwent gastric banding reported problem alcohol use.

    Starting in 2006, King and her colleagues followed more than 2,000 patients participating in the National Institutes of Health-funded Longitudinal Assessment of Bariatric Surgery-2 (LABS-2), a prospective observational study of patients undergoing weight-loss surgery at one of 10 hospitals across the United States.

    RYGB, a surgical procedure that significantly reduces the size of the stomach and changes connections with the small intestine, was the most popular procedure, with 1,481 participants receiving it. The majority of the remaining participants, 522 people, had a less invasive procedure — laparoscopic adjustable gastric banding — where the surgeon inserts an adjustable band around the patient’s stomach, lessening the amount of food the stomach can hold. That procedure has become less popular in recent years because it doesn’t result in as much weight loss as RYGB.

    Both groups of patients increased their alcohol consumption over the seven years of the study; however, there was only an increase in the prevalence of alcohol use disorder symptoms, as measured by the Alcohol Use Disorders Identification Test, following RYGB. Among patients without alcohol problems in the year prior to surgery, RYGB patients had more than double the risk of developing alcohol problems over seven years compared to those who had gastric banding.

    “Because alcohol problems may not appear for several years, it is important that doctors routinely ask patients with a history of bariatric surgery about their alcohol consumption and whether they are experiencing symptoms of alcohol use disorder, and are prepared to refer them to treatment,” said King.

    The American Society for Metabolic and Bariatric Surgery currently recommends that patients be screened for alcohol use disorder before surgery and be made aware of the risk of developing the disorder after surgery. Additionally, the society recommends that high-risk groups be advised to eliminate alcohol consumption following RYGB. However, given the data, King suggests that those who undergo RYGB are a high-risk group, due to the surgery alone.

    The LABS-2 study was not designed to determine the reason for the difference in risk of alcohol use disorder between surgical procedures, but previous studies indicate that, compared with banding, RYGB is associated with higher and quicker elevation of alcohol in the blood. Additionally, some animal studies suggest that RYGB may increases alcohol reward sensitivity via changes in genetic expression and the hormone system affecting the areas of the brain associated with reward.

    In addition to RYGB, the LABS-2 study identified several personal characteristics that put patients at increased risk for developing problems with alcohol, including being male and younger, and having less of a social support system. Getting divorced, a worsening in mental health post-surgery and increasing alcohol consumption to at least twice a week also were associated with a higher risk of alcohol use disorder symptoms.

    King and her team found that although RYGB patients were nearly four times as likely to report having received substance use disorder treatment compared with banding patients, relatively few study participants reported such treatment. Overall, 3.5 percent of RYGB patients reported getting substance use disorder treatment, far less than the 21 percent of patients reporting alcohol problems.

    “This indicates that treatment programs are underutilized by bariatric surgery patients with alcohol problems,” said King. “That’s particularly troubling given the availability of effective treatments.”

    One in five patients who undergo one of the most popular weight-loss surgical procedures is likely to develop problems with alcohol

    Source:Science Daily

  • Ebola kills 3 in DRC, WHO says; scores more linked to deaths

    {Three people have died from an Ebola outbreak in a remote northern region of the Democratic Republic of Congo, as health officials travel to the central African country in response to a rising number of suspected cases, the World Health Organization says.}

    Last week, WHO reported one Ebola-related death and the possibility of two others. On Saturday, the organization confirmed the other two deaths were also Ebola-related.

    The first case, which came April 22, involved a 45-year-old man. The taxi driver who took the man to the hospital and a person who cared for the man both became sick and later died, WHO said.

    All three deaths came in the Likati health district of Bas-Uele province, which borders the Central African Republic.

    Bas-Uele province, with a population of 900,000 in 2007, is mostly inhabited by the Boa tribe, which subsists through farming and hunting and conducts some trade by way of the Uele River.

    Health officials are investigating 17 other suspected cases, Dr. Ernest Dabire, WHO’s health cluster coordinator, said Sunday in Kinshasa. He further estimated that 125 people had been linked to the confirmed Ebola cases and urged the public to be vigilant and visit their doctor if they experience fever or other symptoms.

    Symptoms such as fever, headache, muscle pain, fatigue, diarrhea, vomiting, abdominal pain and hemorrhaging can begin two to 21 days after exposure.

    Though the scope of the outbreak is not yet known, WHO is not recommending any restrictions on trade with or travel to DRC.

    {{Team heads to epicenter}}

    Ebola is a highly infectious virus spread through contact with bodily fluids, and testing shows the latest outbreak involves the Zaire strain, the most dangerous of the viruses known to cause the disease.

    A 2007 outbreak of this strain in Congo had a fatality rate of 74 percent, claiming 200 lives.

    On Saturday, Dr. Matshidiso Moeti, WHO’s regional director for Africa, met with national authorities in Kinshasa to discuss ways to mount a response to the outbreak.

    “WHO has already mobilized technical experts to be deployed on the ground and is ready to provide the leadership and technical expertise required to mount a coordinated and effective response,” Moeti said.

    Three days prior, a team led by the DRC’s Health Ministry began the trek to the Likati health zone to begin an investigation. The 1,400-kilometer (870-mile) route from Kinshasa to Likati is remote and isolated with limited transportation networks, requiring two to three days of travel.

    The team included epidemiologists, biologists and specialists in the areas of social mobilization, risk communication, community engagement and water, hygiene and sanitation, said Dr. Allarangar Yokouidé, a WHO representative.

    There is no approved vaccine to prevent the virus, and there is no approved treatment or cure. Clinical trials of an experimental vaccine are ongoing in West Africa.

    {{DRC’s past experience important}}

    The US Centers for Disease Control and Prevention has been briefed on the outbreak and stands ready to provide epidemiological or laboratory support, if necessary, said spokeswoman Amy Rowland. The CDC has a team in the country working on a monkeypox vaccine trial, she said.

    Médecins Sans Frontières, the United Nations Children’s Fund and other international organizations are standing by as well, WHO said last week.

    Rowland pointed out that DRC has extensive experience with Ebola, this being the country’s eighth outbreak since the virus was discovered near the Ebola River in 1976.

    The last outbreak in 2014 in DRC’s Boende region — an event unrelated to the 2014 West Africa outbreak that killed thousands — was short-lived, as a team of field epidemiologists quickly stopped the spread of the disease, limiting it to 66 cases, 49 of them fatal.

    These “disease detectives” are in a good position to help with the current outbreak, Rowland said.

    Aside from the 1976 outbreak in DRC, which killed 280 people in Yambuku, the deadliest outbreak came in 1995, when Ebola killed 250 people in Kikwit.

    In 2014, more than 11,300 people were killed in the worst-ever outbreak of the virus in West Africa, most of them in Guinea, Sierra Leone and Liberia. During that outbreak, which WHO declared a “public health emergency of international concern,” the Western Hemisphere also saw its first Ebola patients.

    Seven Americans who had been working in Africa became infected and were transported to the United States for treatment. In addition, two American nurses were infected after caring for a Liberian man who died from the virus in the hospital where they worked in Texas.

    Source:Fox 61

  • Path to end HIV could be within reach for United States in next decade

    {2025 could mark turning point toward a declining HIV epidemic}

    The United States could be on track within the next decade to see significant steps towards ending the HIV epidemic in this country, suggests new research from the Johns Hopkins Bloomberg School of Public Health and Brigham and Women’s Hospital.

    The researchers say their findings reveal that, with adequate commitment, a path exists to eliminate domestic HIV infection through the achievement of critical milestones — specifically, the reduction of annual new infections to 21,000 by 2020 and to 12,000 by 2025. They say that if these goals were met, 2025 could be the turning point for the epidemic, when HIV prevalence, or the total number of people living with HIV in the United States, would start to decline. The report is published May 15 online in the American Journal of Preventive Medicine.

    “While these targets are ambitious, they could be achieved with an intensified and sustained national commitment over the next decade,” says study co-author David Holtgrave, PhD, chair of the Department of Health, Behavior and Society at the Bloomberg School. “It’s critical to note that the key to ending the HIV epidemic domestically lies in our collective willingness as a country to invest the necessary resources in HIV diagnostic, prevention and treatment programs.”

    For their study, the researchers used HIV surveillance data published by the Centers for Disease Control and Prevention (CDC) for the years 2010 to 2013 to project yearly estimates for several key indicators — the number of new infections occurring annually, the number of people living with HIV in the United States, and the mortality rate — for 2014 through 2025.

    The researchers used these projections to forecast the potential trajectory of the epidemic if the United States were to achieve certain benchmarks set by the National HIV/AIDS Strategy (NHAS), which was first released by President Obama in 2010 and updated in 2015 with targets to be met by 2020. The NHAS targets for 2020 include a”90/90/90″ goal, which proposes that by 2020, 90 percent of people living with HIV will know their HIV status; 90 percent of people diagnosed with HIV will receive sustained, quality HIV care; and 90 percent of people on antiretroviral therapy (ART) will achieve viral suppression, or an undetectable level of virus in the blood. For their projection of the potential course of the epidemic from 2020 to 2025, the researchers proposed a “95/95/95” goal and assessed achievement of the NHAS targets at 95 percent levels by 2025.

    Their analysis revealed that if the NHAS targets — “90/90/90” for 2020 and “95/95/95” for 2025 — were achieved, the number of new HIV infections in the United States would drop from 39,000 in 2013 to approximately 20,000 in 2020, or a 46 percent decrease, and to about 12,000 in 2025, a nearly 70 percent reduction. Additionally, the total number of deaths among people living with HIV would decline from 16,500 in 2013 to approximately 12,522 in 2025, a 24 percent decrease, and the mortality rate would drop from 1,494 deaths per 100,000 people living with HIV in 2013 to around 1,025 in 2025, a 31 percent decrease.

    “If the United States were to reduce the number of new HIV infections to 12,000 by 2025, this would mark an important inflection point in the HIV epidemic in this country,” says study leader Robert Bonacci, MD, MPH, a resident physician in the Department of Medicine at Brigham and Women’s Hospital. “It would be the first year that the number of new infections drops below the simultaneously decreasing number of deaths among people living with HIV. This is critical, because if new infections decline faster than the number of deaths, the total number of people living with HIV in the United States would begin to decrease, meaning the United States would be on course to end the epidemic.”

    Advancements in antiretroviral therapy (ART) — the lifesaving drugs that reduce HIV transmission by lowering the level of virus in the blood — mean that HIV can now be a manageable chronic disease. In the United States, the average life expectancy for people living with HIV continues to increase toward that of the general population. Yet, of the more than one million people living with HIV, many lack access to ART.

    Additionally, certain populations — particularly gay men, young people, transgender people, black and Hispanic Americans and those who live in southern states — continue to be disproportionately affected, and the overall progress has not been felt equally across all communities.

    Is the end of the HIV epidemic within sight?

    Source:Science Daily

  • World Health Organization confirms second Ebola case in DRC and fears 17 more

    {The World Health Organization (WHO) has confirmed a second case of Ebola in the Democratic Republic of Congo (DRC) and suspects 17 others.}

    On Friday the WHO reported that one person in the DRC had died from the virus.

    The WHO said they are attempting to trace 125 other people thought to be linked to Ebola cases in the outbreak.

    Ebola is a deadly hemorrhagic fever that occasionally jumps to humans from animals, including bats and monkeys.

    The last outbreak of Ebola in DRC was in 2014 when the country recorded several dozen cases, but WHO has warned that the deadly virus could resurface at any time as it can linger in the eyes, central nervous system and bodily fluids of some survivors.

    The 2014 outbreak in DRC was unconnected to the epidemic in West Africa, which killed thousands and became the worst Ebola outbreak on record.

    An experimental vaccine was recently developed that WHO says could be used in emergencies.

    An Ebola virus virion is seen in this electron micrograph image

    Source:ITV