Public Health
Exciting new avenues of research and policy drive expansion of HIV treatment access, use of antiretrovirals to prevent infections and pursuit of a cure
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The unwillingness of the global AIDS community to accept the status quo is fuelling a new era of scientific innovation to drive novel ways of treating and preventing HIV, organizers of the XVIII International AIDS Conference (AIDS 2010) taking place in Vienna, Austria said today. And, with millions of lives dependent on expanding access to antiretroviral treatment to all those clinically in need, researchers and clinicians are partnering in new ways to find the most effective and efficient methods to deliver treatment and strengthen health systems. A new Medicines Patent Pool described in today’s plenary session also offers the possibility of broader access to more effective and less toxic regimens.
“The inspiring element of the conference so far has been the marriage of cutting edge science and innovative policy and programming,” said Dr. Brigitte Schmied, AIDS 2010 Local Co-Chair and President of the Austrian AIDS Society. “We need that same energy and creativity to break through the HIV-related stigma and discrimination that prevents too many from benefitting from the knowledge we already have about how to save lives.”
Growing evidence of the power of antiretroviral drugs to prevent new infections offers the possibility of a major step toward universal access to HIV prevention while increasing access to lifesaving care. The use of treatment science to develop new prevention modalities, such as the antiretroviral-based vaginal microbicide used in the CAPRISA trial, whose results were released this week, is a further example of the drive to provide a variety of effective new prevention options.
Human rights protections essential in drive for universal access
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The call for human rights as a fundamental component of efforts to prevent new infections and provide treatment for people living with HIV pervaded the XVIII International AIDS Conference today as delegates and local residents prepared for the HIV and Human Rights March through the streets of Vienna this evening. Conference participants are giving voice to the conference theme of Rights Here, Right Now through a number of plenary presentations, sessions, and Global Village and Youth Programme activities.
The examination of the rights of women in the context of HIV took on a powerful new dimension with the release Monday evening of the CAPRISA 004 microbicide trial results. The study provides the first data demonstrating the effectiveness of an antiretroviral-based vaginal microbicide in reducing a woman’s risk of sexually transmitted infection with HIV and genital herpes. The trial tested the safety and effectiveness of a 1% tenofovir gel among nearly 900 women at two sites in South Africa. As today’s plenary speaker Everjoice Win noted, women have a greater likelihood of being on the receiving end of violent or coercive sexual intercourse and these results are a significant step toward a tool that puts the power of HIV prevention in women’s hands. The CAPRISA trial results will be presented at 13:00 in Session Room 7.
Your doctor’s notes, with the click of a mouse
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After your next appointment, would you want to read everything your doctor wrote about you and your health?
Researchers are betting that you would - or at least that if you tried it, you would like it. They’re testing out a new system that lets patients see the doctor’s notes from their primary care visit via the internet.
“The whole idea here is to improve (and) expand the dialogue between patients and physicians,” Jan Walker, an instructor at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston and one of the study’s lead researchers, told Reuters Health.
Doctors often don’t report impaired colleagues
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One out of three doctors didn’t report colleagues they believed were “impaired or incompetent” to authorities, a survey released today found. Slightly more—36 percent—didn’t completely agree that it was their responsibility to report these colleagues in every case.
The definition of impaired or incompetent can range from doctors with drug addictions to those that aren’t up-to-date on the best way of treating some conditions.
The American Medical Association (AMA) has a policy stating that doctors are ethically bound to report colleagues they believe are unfit to practice.
UK health shake-up puts doctors in charge of funds
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Britain’s new coalition government, seeking to cut a record budget deficit, announced a radical shake-up of its sprawling health service on Monday.
The reorganisation of the world’s largest public healthcare system will see family doctors take charge of the lion’s share of a 110 billion pound ($165 billion) healthcare budget.
Losing out will be thousands of managers in the National Health Service (NHS) whose jobs will be cut to slash bureaucracy and save money.
Dogs may help collar Chagas disease
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Chagas disease, for example, is caused by a parasite that roams with only limited control among the rural poor in Latin America. The main vector for the parasite Trypanosoma cruzi is the triatomine insect, or “kissing bug,” which thrives in the nooks and crannies of mud-brick dwellings. The bug sucks the blood of mammals, helping T. cruzi move between wildlife, cats, dogs and humans.
“Dogs tend to lie on porches or other areas easily accessible to the bugs,” says disease ecologist Uriel Kitron, chair of environmental studies at Emory University. “And when a dog is malnourished and its immune system isn’t great, they are even more at risk.”
Kitron has been researching Chagas disease in remote communities of northern Argentina for the past 10 years. “One of our most significant findings is the importance of dogs in both the spread of the disease, and the potential to help control it,” he says, explaining that dogs can make good sentinels for health officials monitoring T. cruzi transmission.
Researchers Discover New Way Diseases Develop
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Researchers from Mount Sinai School of Medicine have identified a previously unknown mechanism by which cells direct gene expression, the process by which information from a gene is used to direct the physical and behavioral development of individuals. The research, which may help scientists gain insight into how muscle and heart diseases develop, is published in the July 8th issue of Nature.
Using a combined approach of structural and molecular biology, a team of researchers led by Ming-Ming Zhou, PhD, Professor and Chair, Structural and Chemical Biology, Mount Sinai School of Medicine, determined that the molecular interactions between proteins are very different than previously thought, and that they play an essential role in the initiation of gene transcription of muscle and the heart. Gene transcription is the first step to gene expression, a cellular process that occurs in response to physiological and environmental stimuli, and is dictated by chemical modifications of the DNA and histones, which are the proteins responsible for packaging the DNA.
US cancer death rates continue drop: report
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U.S. cancer death rates are falling, with big decreases in major killers such as colon and lung cancer, the American Cancer Society said on Wednesday.
The improvement was due a decline in smoking, better treatment and earlier detection, it said.
The group predicted 1,529,560 new cancer cases in the United States in 2010 and 569,490 deaths.
ICU death rates higher on weekends: study
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It’s not something you can control, but when you or a loved one is admitted to an intensive care unit may be linked to your survival: Patients treated in an intensive care unit on a weekend may be more likely to die during the hospital admission than those admitted on a weekday, a new study suggests.
The findings, from an analysis of 10 international studies, add to evidence that patients admitted to a hospital during “off-hours” tend to fare worse.
Studies have found, for instance, that heart attack and stroke patients admitted during hospital off-hours—overnight or on the weekend—have a higher risk of dying than those admitted on weekdays. There is also evidence of a relatively higher risk of childbirth complications when women deliver at night, though the absolute risk is still quite low.
Health and austerity: When budget cuts cost lives
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European leaders slicing away at national budgets are keen to persuade voters that healthcare is sacrosanct, but they will struggle to escape the truth that cutting spending elsewhere also eventually costs lives.
If a government’s first priority is to protect the lives of its people, then ringfencing health spending while cutting other budgets and trying to drive down the cost of medicines—policies being pursued in Europe—seem sensible options.
Yet experts say the planned cuts in welfare and other state programmes will hit everything from pensions to housing to playgrounds, all of which also affect the health of nations.
Virginia, government square off over healthcare
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The state of Virginia and the government were pitched in a legal battle in a federal courtroom on Thursday that could lead to the undoing of the massive healthcare reform law passed three months ago.
Judge Henry Hudson of the U.S. District Court for the Eastern District of Richmond heard the federal government’s arguments to dismiss a lawsuit filed by Virginia that contends the healthcare law’s requirement that all Americans have health insurance is unconstitutional.
Before President Barack Obama signed the radical overhaul of the multibillion dollar health insurance industry into law, Virginia’s legislature passed its own law that took effect on Thursday that says no one could be mandated to buy health insurance.
Consulting ‘Dr. Google’
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The quality of online information about the most common sports medicine diagnoses varies widely, according to a study published in the July 2010 issue of the Journal of Bone and Joint Surgery (JBJS). Therefore, patients who use the Internet to help make medical decisions need to know that the web may not be giving the whole picture.
“The reason that we decided to undertake this study is that patients are presenting to their physicians office with increasing frequency armed with printouts of information obtained from the Internet,” said Madhav A. Karunakar, MD, an orthopaedic surgeon at Carolinas Medical Center in Charlotte, N.C., and one of the study’s authors. “Physicians and patients should be aware that the quality of information available online varies greatly. Additionally, physicians should be prepared to discuss this information with their patients in order to ensure that it is not misinterpreted.”
Nearly three-quarters of the U.S. population has access to the Internet, and more than half of those people go online for health-related information at least once a month. However, quality controls over the health information found on the web have not grown at the same rate that Internet use has.
Frozen blood a source of stem cells, study finds
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Frozen blood from stored samples can be used to make cells resembling stem cells, researchers said on Thursday - opening a potential new and easier source for the valued cells.
They used cells from blood to make induced pluripotent stem cells or iPS cells - lab-made cells that closely resemble human embryonic stem cells but are made from ordinary tissue.
These iPS cells have in the past been made from plugs of skin, but blood is much easier to take from people and to store, the researchers reported in the journal Cell Stem Cell.
Bees help to beat MRSA bugs
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Bees could have a key role to play in urgently-needed new treatments to fight the virulent MRSA bug, according to research led at the University of Strathclyde.
The scientists found that a substance known as beeglue or propolis, originating from beehives in the Pacific region, was active against MRSA, which causes potentially fatal infections, particularly in hospital patients.
The bug was either the underlying cause or a contributory factor in more than 1,900 deaths between 1996 and 2008.
Ten years on, genomic revolution only just starting
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The 10-year-old Human Genome Project has only just begun to bring to fruition its promise to transform medicine, its founders said on Thursday.
Francis Collins, who led the U.S. component of the project and is now director of the U.S. National Institutes of Health, said that although it may seem that the revolution promised with the publication of the first draft in 2000 is slow in coming, many early predictions had been prematurely hyped.
Scientists have barely scratched below the surface of the possibilities opened up by having access to the whole human gene map, he said, and when they do, their results will determine the way all people are diagnosed and treated for diseases.
