Measles still poses threat to US, health officials warn

Private school children at greatest risk of measles says leading doctor

Private school pupils ‘at greatest measles risk’

Although measles was officially “eliminated” in the United States in 2000, public health officials warned Thursday that the highly contagious, and sometimes deadly, virus continues to be imported from Europe and other parts of the world where the disease is still common. Despite high vaccination rates nationwide, measles continues to cause outbreaks in individual communities with large numbers of unvaccinated persons.

Between January 1 and August 24 of this year, the Centers for Disease Control and Prevention (CDC) received reports of 159 laboratory-confirmed measles cases. Federal health officials say all of the U.S. cases so far this year involve persons who either acquired the virus while traveling outside the U.S. or were exposed to an infected international traveler.

According to the CDC, at least 82 percent of the cases involved patients who had not been vaccinated. An additional 9 percent of the patients had unknown vaccination statuses.

Of the patients who had not received measles immunizations, 79 percent had philosophical objections to vaccination, federal health officials said.

Results of a National Immunization Survey released today show that 90.8 percent of U.S. toddlers between the ages of 19 and 35 months have received at least one dose of the measles, mumps and rubella vaccine (MMR) – just above the federal government’s target of 90 percent. However, federal health officials warned that measles imported from other countries can still cause large outbreaks in the U.S., especially if introduced into areas with clusters of unvaccinated persons.

Such clusters can exist in homes, neighborhoods, schools or religious organizations, with heavy concentrations of people who are opposed to vaccination.

Such was the case in New York City back in March. An unvaccinated 17-year-old infected with measles returned from a trip to the United Kingdom and is suspected to be the source of the largest U.S. outbreak of the disease since 1996. Public health officials identified 58 measles cases in two Brooklyn neighborhoods, all involving people who had not been vaccinated.

Fortunately none of the U.S. cases this year has resulted in death, and CDC officials said all of the outbreaks of 2013 have been contained, thanks to high vaccination rates and rapid response by public health agencies. However, they continue to urge Americans to get vaccinated because the disease is easily transmitted.

“You can bring measles virus into an arena, and anyone who’s not vaccinated in that arena who’s never had measles is going to get that virus,” said Dr. Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases.

Since elimination in 2000, the largest number of U.S. measles cases was reported in 2011, with 220 people becoming ill.

Source: Fox news

Maternal PTSD linked to children’s trauma

Tthe effects of maternal mental health difficulties can be especially problematic in early life, from pregnancy to age 5

The children of mothers with post traumatic stress disorder (PTSD) may be at high risk of being traumatized themselves, according to a small new study in urban U.S. neighborhoods.

Inner-city kids whose mothers had PTSD experienced more traumatic events – such as neighborhood shootings, domestic violence, dog bites or car accidents – before age five than kids whose mothers were depressed or had no mental health issues, researchers found.

Mothers with a combination of PTSD and depression were also more likely to report psychologically or physically abusing their child, compared to mothers with just one of those disorders.

“The main take-home message is that when parents are suffering, their children suffer, too,” said Dr. Howard Dubowitz, professor of pediatrics at University of Maryland School of Medicine in Baltimore.

“Those of us who are involved in helping to take care of kids can’t ignore what problems mothers and fathers may be struggling with,” added Dubowitz, who was not involved in the study.

Children exposed to trauma are themselves at greater risk of a mix of health challenges later on in life, such as obesity, drug and alcohol addictions, heart disease, suicide and mental health disorders, experts said.

“Everyone’s been putting the focus on depression, even though PTSD and depression run together,” said the study’s lead author Claude Chemtob, director of NYU Langone Medical Center’s family trauma research program.

He and his colleagues recruited 97 mothers with children between the ages three and five years old from Mount Sinai School of Medicine’s pediatric primary care clinics in New York City to participate in the study.

Most mothers were from ethnic minority groups and had high school diplomas. The women all completed questionnaires designed to detect depression or PTSD symptoms. They also answered questions about violent events their children had witnessed.

The majority of mothers were not clinically depressed or suffering from PTSD, Chemtob’s group reports in JAMA Pediatrics. Of the 97 mothers, 11 had diagnosable depression, six had PTSD and 10 had a combination of both.

Chemtob pointed out that the study population had slightly elevated levels of depression and PTSD diagnoses compared to national averages.

The researchers also found that mothers with PTSD and depression reported far greater parenting stress. “In short, their experience of parenting is that it is more difficult and less rewarding,” Chemtob said.

Last year the American Academy of Pediatrics urged pediatricians to take steps to reduce childhood “toxic stress” that can occur when parents or caregivers suffer from poor mental health.

In the current study, the children of mothers with PTSD witnessed an average of five traumatic events.

Their peers whose mothers were only depressed or had no mood disorder experienced an average of only one traumatic event. A third group of kids with mothers suffering both PTSD and depression experienced nearly four events.

Previous research suggests that nearly half of women with PTSD may also suffer from depression.

“We know that the effects of maternal mental health difficulties can be especially problematic in early life, from pregnancy to age 5,” Michelle Bosquet of Boston Children’s Hospital in Massachusetts told Reuters Health in an email.

Bosquet, who was not involved in the new study, added that much previous research has focused only on depression and less is known about how PTSD may influence parenting.

Researchers noted that the study is limited by its small size.

“These results have been found among certain families,” Dubowitz said. Future studies could look for the same results in different populations, such as whites, he said.

The authors encourage screening mothers for PTSD alongside depression in pediatric primary care settings. “This might be an effective way to intervene on child maltreatment,” Chemtob told Reuters Health.

In his research on child abuse, Dubowitz has created a questionnaire for parents to complete before arriving for a pediatric appointment. It contains two questions to detect depressive symptoms.

“It may be most efficient to use just two questions to identify possible depression, and, in so doing, identify parents with that condition and … help them get evaluated,” Dubowitz said.

“Aside from time, and time is very important, there is the whole challenge of changing health professionals’ practice and behavior,” he said.

Source: Fox news         

What makes cholera toxin so deadly

cholera toxin acts by two entirely distinct, but cooperating mechanisms to produce diarrhea

Researchers have identified an underlying biochemical mechanism that helps make cholera toxin so deadly, often resulting in life-threating diarrhea.

Two groups of scientists at the University of California, San Diego, worked on fruit flies, mice and cultured human intestinal cells to study cholera toxin, produced by the highly infectious bacterium Vibrio cholerae.

They discovered the toxin exerts some of its devastating effects by reducing the delivery of proteins to molecular junctions that normally act like Velcro to hold intestinal cells together in the outer lining of the gut.

The UC San Diego researchers found that cholera toxin acts by two entirely distinct, but cooperating mechanisms to produce diarrhea. In addition to increasing the efflux of chloride ions through a protein channel called CFTR, it weakens cell junctions to allow a rapid outflow of counterbalancing sodium ions and water between the cells.

The scientists showed that many of the effects of the cholera toxin on the gut could be reversed by genetic manipulations that bolster the delivery of proteins to these junctions.

Understanding this novel mechanism of cholera action could also have important implications for other disorders of intestinal barrier function such as Crohn’s disease, colitis and celiac disease.

The study is published in the journal Cell Host and Microbe.

 

US firm brings next generation pacemaker in India

St Jude Medical Inc, a global medical device company, today announced the launch of next generation pacemaker in India.

The NYSE-listed firm announced the first commercial implant of `Allure Quadra’, a cardiac resynchronisation therapy pacemaker (CRT-P), in the country.

The first-to-market quadripolar pacemaker system offers more pacing options for patients with heart failure (HF), a company release said here.

Quadripolar leads allow for increased implant efficiencies, which clinical data indicates can result in fewer surgical revisions. Broad clinical evidence on the advantages of the quadripolar technology has been documented in more than 100 publications worldwide, it said.

Explaining how this new technology works, Anil Saxena of Fortis Escorts Hospital, said: “Historically, pacing systems that treat heart failure included a lead with only one electrode in the heart. Later, these were replaced by leads with two electrodes.

“Nearly 40 per cent of patients do not effectively benefit from traditional pacing due to potential complications all of which require repeat surgeries.”

The new technology has four electrodes and 10 programmable pacing configurations, allowing electro-physiologists to manage their patients with greater flexibility and improved patient outcomes, Saxena said.

The worldwide prevalence of heart failure has been rising over the last few decades. More than 26 million people globally suffer from HF, with a prevalence rate in India estimated to range from 1.3 to 4.6 million people.

Centre will set up 20 new state cancer institutes: Azad

   The Centre will set up 20 new state cancer institutes across the country along with 23 new tertiary cancer centers to address the increased requirement of cancer-related treatments in the country, Union Health Minister Ghulam Nabi Azad said today.

“The central government last week has approved funds for establishment of these institutes and also the existing 27 regional cancer care centers will be strengthened,” Azad said.

This initiative will add 70 state-of-the-art tertiary cancer centers in government sectors, the Minister said while addressing the 41st convocation of AIIMS here.

A National Cancer Institute with state-of-the-art research and patient care facilities would be established at Jhajjar in Haryana, where the government has acquired 300 acres of land for teaching and research requirements of AIIMS, he said.

Azad said the government has upgraded 19 institutions and it intends to take up another 29 government medical colleges for up gradation in the 12th plan period.

He said work on the seventh AIIMS at Rae Bareli would start soon with the land being acquired and the tendering process at an advanced stage.

The process of setting up an AIIMS in Raiganj in West Bengal is under way, he said.

The Minister, however, said these ambitious projects and their effective implementation require availability of large number of trained and skilled human resources.

He said the government has allocated additional financial resources for modernization of existing facilities at AIIMS here, which is under severe strain due to increased patient load.

“Due to the implicit faith of the people in the patient care services at this institute, nearly 10,000 patients visit the AIIMS OPD every day from all parts of the country,” he said.

The Minister conferred degrees on 509 newly graduated doctors. The program was also attended by Margaret Chan, Director General of the World Health Organization.

Chan gave away medals for meritorious academic excellence to 29 students. She said the new doctors symbolize India’s aspirations and advised the students to serve the poor and vulnerable sections of society.

She advised them to serve with humanity, quoting Mahatma Gandhi that ‘Service without humanity’ is a deadly sin.

Why chocolates, olive oil and tea are healthy for you

Researchers are focusing on the healthful antioxidant substances in red wine, dark chocolate, olive oil, coffee, tea, and other foods and dietary supplements.

Researchers are focusing on the healthful antioxidant substances in red wine, dark chocolate, olive oil, coffee, tea, and other foods and dietary supplements.

The American Chemical Society, the world’s largest scientific society, is holding a symposium on those substances during its 246th National Meeting and Exposition.

Reports in the symposium involve substances that consumers know best as ‘antioxidants,’ and that scientists term ‘ phenolic derivatives.’

These ingredients, found naturally in certain foods and sold as dietary supplements, have been linked with health benefits that include reducing the risk of heart disease and cance

Long-lasting chest pains indicator of heart attack!

Researchers have claimed that patients suffering long-lasting chest pain are likelier to have a heart attack than those with pain of a shorter duration.

James McCord, M.D., a cardiologist at Henry Ford Hospital on the research team, said that patients can experience varying strength, location, and duration of chest pain, asserting that the variety of symptoms any one patient may experience during a heart attack is a challenge to the physician who is trying to distinguish between patients who are having a heart attack and those who are not.

Of 426 patients included in the study, 38 (less than 9 percent) had a final diagnosis of heart attack, with average chest pain duration of 120 minutes, compared with 40 minutes in patients without heart attack.

In patients with chest pain lasting less than five minutes, there were no heart attacks and no deaths at 30 days.

McCord said that these findings suggest that patients with chest pain lasting less than five minutes may be evaluated as an out-patient in their doctor’s office; while patients with chest pain greater than 5 minutes, without a clear cause, should seek prompt medical evaluation in an emergency department.

Patients were interviewed during the study to determine medical history and demographics. Those with a diagnosis of heart attack were significantly older.

The study has been published in Critical Pathways in Cardiology.

 

Would you know if you were suffering from a hernia?

Did you know that you could suffer from a hernia almost suddenly? Or you might not even know you have one? Yup, doctors say that you may be diagnosed as having a hernia either during a regular medical checkup or it may strike suddenly, requiring a trip to the emergency room.

An abdominal hernia is a soft swelling seen over the abdominal wall and is a condition that afflicts more men than women. It’s formed due to an area of weakness in the muscles of the abdominal wall. In its initial stages, it is seen when the person is either standing, walking, coughing or lifting heavy objects and disappears when you lie down. At this stage, it can still be pushed back into the abdomen. It is when it becomes hard and cannot be pushed back that it causes a problem.

If you are obese, suffer from constipation, apply too much pressure while urinating, have a job that requires you to lift heavy weights, have people in your  immediate family who suffer from the condition or have had a recent surgery in the abdomen, you are more prone to developing a hernia. Even though statistically males are more prone to the disease that does not mean that women are can’t have them.

What makes this condition so unique and generally recurrent is the fact that it is a bilateral disease. This means that if a hernia forms on one side of the body (as in an inguinal hernia) it is very likely that the patient can develop one on the other side as well.

One of the most glaring and important symptoms is the formation of a bulge or lump on the surface of the body associated with pain. This usually happens only in areas like the stomach, groin or a part that has had some kind of surgical procedure. Other signs include a painful swelling that does not reduce on its own or on being pushed back, nausea, vomiting and abdominal bloating.  If left untreated, apart from being extremely painful and uncomfortable it can lead to twisting or torsion of the part that come out of the herniated space. If that is not treated at the earliest, the organ can die and become gangrenous which can then lead to the spread of toxins throughout the body, a condition also known as septicaemia. So getting treated quickly and appropriately is of utmost importance.

If you do suffer from these symptoms your doctor will most likely come to the conclusion that you are suffering from a hernia. In order to diagnose the condition he/she may do a physical exam to understand the severity of the condition. If he/she requires a better insight he/she may order an ultrasonography as well.

Based on the location of the hernia, your doctor will classify it into any one of the five types – inguinal hernias that are found in the groin, umbilical hernias found at the navel, ventral hernias found on the abdominal wall, incisional hernias present at a previous surgery site and femoral hernias found right above the thigh – and decide a method of treatment. Of all the hernias, almost 75% of the people suffer from an inguinal hernia and about 10% suffer from umbilical hernias.

Once diagnosed, the treatment options greatly depend on the severity of the symptoms. Most doctors will likely monitor the size of the hernia and its associated symptoms to see if it increases over a period of time. There are mainly two methods a doctor can use – a surgical method and a non surgical one.

In order to choose a non-surgical approach the doctor will see that there is not much swelling or bulging in the area. He will then use external help like that of a supportive truss to push back the hernia.

Surgical intervention is used only in more complicated and severe cases. And your doctor will choose to perform any one of the two types of surgeries – laproscopic and open surgery. While a laproscopic surgery is conservative and involves the use of a camera and a scope inserted into the body to fix the hernia, an open surgery is more invasive and requires a large incision along the part where the hernia is present.

How hernia surgery works is that it strengthens the wall of the abdomen by the placement of a prosthetic mesh. This mesh acts as a bridge in the area of muscle weakness. The body tissues grow into the mesh thus repairing the muscle gap, strengthening the abdominal muscle and helps repair the hernia.

While anyone who is fit to undergo general anaesthesia can have a hernia repair surgery, the choice of using an open surgery or laparoscopic surgery greatly depends on the type of hernia. For example laparoscopy is especially performed for an inguinal hernia, since they usually tend to be recurrent and bilateral. A laparoscopic approach is better for quick recovery and is less invasive. In the case of a small inguinal hernia or an umbilical hernia, it has to be treated with open surgery.

 

Anorexia linked to how cholesterol processes in our body

Scientists have linked the eating disorder anorexia to variants in a gene coding for an enzyme that regulates cholesterol metabolism.

The study suggests that anorexia could be caused in part by a disruption in the normal processing of cholesterol, which may disrupt mood and eating behavior.

For this project-the largest-ever sequencing study of anorexia – Nicholas J. Schork, a professor at The Scripps Research Institute (TSRI) worked with an international team of collaborators representing more than two dozen research institutions.

The project made use of genetic information from more than 1,200 anorexia patients and nearly 2,000 non-anorexic control subjects.

For an initial “discovery” study in 334 subjects, the researchers catalogued the variants of a large set of genes that had already been linked to feeding behavior or had been flagged in previous anorexia studies.

Of more than 150 candidate genes, only a handful showed statistical signs of a linkage with anorexia in this group of subjects.

One of the strongest signs came from the gene EPHX2, which codes for epoxide hydrolase 2-an enzyme known to regulate cholesterol metabolism. ”

The team followed up with several replication studies, each using a different cohort of anorexia patients and controls, as well as different genetic analysis methods. The scientists continued to find evidence that certain variants of EPHX2 occur more frequently in people with anorexia.

Schork noted that people with anorexia often have remarkably high cholesterol levels in their blood, despite being severely malnourished.

The study has been published online in the journal Molecular Psychiatry.

 

New vaccine promises to treat AIDS

Researchers have developed a vaccine that seems to have the capability of completely clearing an AIDS-causing virus from the body.

The promising vaccine candidate that is being developed at OHSU’s Vaccine and Gene Therapy Institute is being tested through the use of a non-human primate form of HIV, called simian immunodeficiency virus, or SIV, which causes AIDS in monkeys.

Louis Picker, M.D., associate director of the OHSU Vaccine and Gene Therapy Institute, said that the latest research suggests that certain immune responses elicited by a new vaccine may also have the ability to completely remove HIV from the body.

The Picker lab’s approach involves the use of cytomegalovirus, or CMV, a common virus already carried by a large percentage of the population. In short, the researchers discovered that pairing CMV with SIV had a unique effect.

They found that a modified version of CMV engineered to express SIV proteins generates and indefinitely maintains so-called “effector memory” T-cells that are capable of searching out and destroying SIV-infected cells.

T-cells are a key component of the body’s immune system, which fights off disease, but T-cells elicited by conventional vaccines of SIV itself are not able to eliminate the virus.

The SIV-specific T-cells elicited by the modified CMV were different. About 50 percent of monkeys given highly pathogenic SIV after being vaccinated with this vaccine became infected with SIV but over time eliminated all trace of SIV from the body.

In effect, the hunters of the body were provided with a much better targeting system and better weapons to help them find and destroy an elusive enemy.

The research has been published today by the journal Nature.