There's an app for that: An easy, fast and reliable way to record causes of death

Researchers have developed a revolutionary new app to capture accurate global cause of death data on tablets and mobile phones.

Worldwide, two in three deaths - 35 million each year - are unregistered. Around 180 countries that are home to 80 per cent of the world's population do not collect reliable cause of death statistics.

The app is the result of a decade-long global collaboration, led by the University of Melbourne and researchers at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

A new paper, published today in BMC Medicine, explains the process behind the app. The research team redesigned a short 'verbal autopsy' questionnaire and tested it in India, the Philippines, Mexico, and Tanzania. The app was then field-tested in China, Sri Lanka and Papua New Guinea.

Family members of the deceased were given surveys in hand-held devices. A computer then analysed the data to make a diagnosis, bypassing the need to rely on doctors to do this work.

University of Melbourne Laureate Professor Alan Lopez led the study.

Prof Lopez said in the age of big data, we still know next to nothing about what kills people in poor countries.

"Without accurate cause of death information, we can't monitor disease and injury trends, we can't keep track of emerging health problems and we don't have any markers to show us whether programs and policies are actually working.

"So if you live in a country where no-one is dying from malaria, then why are you pouring money into malaria-prevention programs? And conversely, if people are dying from lung cancer, why aren't you investing in tobacco control?

"Up-to-date, reliable information on what people are dying from and at what age, is really important for policies to prevent premature death. Our app provides a way to do this, quickly, simply, cheaply and effectively, in real time, with the power of technology."

IHME Director Dr Christopher Murray added: "Verbal autopsy research has shown that computer models are just as accurate as physicians in making diagnoses based on verbal autopsy data, at a fraction of the cost.

"In countries with scarce data on causes of death, policymakers need this information to better understand local disease burden and effectively allocate resources."

The problem in many regions around the world is that only registered doctors are qualified to determine a cause of death, but the process is expensive, time-consuming and can be unreliable.

Computers can reliably provide a diagnosis by linking symptoms with a specific cause of death in real-time. The instant provision of information overcomes what can be a 10-year lag between the death and the doctor's report.

"Relying on doctors to collect information about causes of death in rural populations is not helpful," Prof Lopez said.

"Our method involves data collection by health workers, registrars and village officials, who use the app to administer the surveys.

"The data is fed into a computer, which makes a diagnosis. It requires very minimal training. This way doctors are free to do what they do best, which is providing essential medical care to their communities.

"Governments now have a way to gather data to inform their health policies, that costs nothing and can be provided in real time. Even if you're sitting out in the remote bush in Africa and you can do this. Anywhere you've got power, it's possible."

Source:UNIVERSITY OF MELBOURNE

Can natural remedies jeopardize cardiovascular health?

Chinese physicians report on the case of a woman who presented with aconitine-induced cardiovascular symptoms. Their report, published in theCanadian Journal of Cardiology, warns that the use of this natural ingredient may lead to severe poisoning.

A 45-year-old Chinese woman was diagnosed with a severe heart-rhythm disorder, bidirectional ventricular tachycardia (BVT), associated with aconitine poisoning. BVT is a rare form of tachycardia (characterized by a resting heart rate over 100 beats per minute) and a distinct pattern of ECG waves on presentation.

The patient's husband reported that she had drunk about 50 milliliters of a medicinal liquid about 30 minutes before she developed a sudden drop in blood pressure and then lost consciousness. The woman had no history of previous heart-rhythm problems and there was no family history of unexpected sudden death or fatal accidents. On examination she had a heart rate of 150 beats per minute and her blood pressure was 50/30. Her skin was cool, moist, and cyanotic. Treatment with the antiarrhythmic agents amiodarone, metoprolol, lidocaine, and potassium chloride was ineffective. An abdominal ultrasound showed marked gastric retention. A gastric tube was used to suction out the contents of her stomach. After two hours, the patient's BVT ceased and her circulation improved.

Investigation revealed that the patient's blood was positive for aconitine, a substance produced by the Aconitum plant, also known as devil's helmet or monkshood. Although well-known for its highly toxic properties, aconitine is the primary ingredient of the traditional Chinese medicine known as Fuzi, a remedy made from the processed lateral roots ofAconitum carmichaeli Debx. It is widely distributed in the southwest provinces of China and is used in small doses for its anti-inflammatory and pain-relieving effects.

"Management of potentially lethal ventricular tachyarrhythmia associated with aconitine poisoning presents a therapeutic challenge. In a previously published case, amiodarone was effective in suppressing the BVT. However, in our patient, both lidocaine and amiodarone were ineffective," explained lead author Zhong Yi, MD, PhD, of the Aerospace Center Hospital, Beijing, People's Republic of China.

"The public should be warned of the risk of severe poisoning that can accompany traditional Chinese medicinal usage of Fuzi," Dr. Yi concluded.

Commenting on the report, P. Timothy Pollak, MD, PhD, FRCPC, of the Department of Medicine at the University of Calgary, Alberta, cautioned that "not all products of Mother Nature are free of harm. This case report reminds us that aconitine is not the only naturally derived substance that can cause potentially lethal ventricular tachyarrhythmias, including BVT. The report also demonstrates the human tendency to think that if a little is good, more must be better."

Dr. Pollak advises clinicians to be aware of what their patients are taking and be prepared to discuss alternative remedies, at least at a basic level. "Dodging the discussion can only lend credibility to any patient suspicions that as a practitioner of Western medicine, you have been denied the secrets of alternative remedies or are hiding them for ulterior motives. This report serves as a timely illustration that alternative remedies do have implications for the practice of cardiology that cannot be ignored."

Source:ELSEVIER HEALTH SCIENCES

Transcendental Meditation and lifestyle modification increase telomerase, new study finds

A new study published in PLOS ONE found that the Transcendental Meditation technique and lifestyle changes both appear to stimulate genes that produce telomerase, an enzyme that's associated with reduced blood pressure, cardiovascular disease, and mortality.

Specifically, these approaches were found to activate two genes that code for telomerase, which adds molecules to the ends of chromosomes, or telomeres, protecting them from deteriorating.

May explain mechanism for known health benefits

"The finding that telomerase gene expression is increased, and that this is associated with a reduction in blood pressure in a high-risk population, suggests that this may be a mechanism by which stress reduction improves cardiovascular health," said Robert Schneider, MD, FACC, coauthor of the study.

Earlier research on the Transcendental Meditation technique found lower rates of high blood pressure, heart attack, stroke, and death, as well as slowing of biological aging. The new study examined what was happening at the level of DNA, showing that the Transcendental Meditation technique increases telomerase gene expression and suggesting that this may contribute to the cardiovascular and aging benefits.

Both groups show improvement after 16 weeks

For this pilot trial, the subjects included 48 men and women with high blood pressure who were recruited and studied at Howard University Medical Center. Half were assigned to a group that learned the Transcendental Meditation technique and received a basic health education course. The other half were assigned to a group that focused on achieving significant lifestyle modifications such as weight reduction, reducing salt intake, engaging in regular physical activity, and moderating alcohol. They also participated in support groups and group exercises.

After 16 weeks, both groups showed significant increases in telomerase gene expression and reductions in blood pressure. There was no significant difference between the changes in the two groups. The results also showed that the lifestyle modification group made a larger number of changes in their lifestyle behaviors.

"These findings are very encouraging for prevention," said Dr. Schneider, director of the Institute for Natural Medicine and Prevention at MUM. "They show that both the Transcendental Meditation technique and active lifestyle modification can contribute to heart health."

Coauthor Otelio Randall, MD at Howard University College of Medicine concluded, "This pilot study in African Americans suggests stress reduction and lifestyle modifications may reduce blood pressure with an increase in telomerase."

Encouraging findings for heart health

"The result is valuable new information, relevant both to cardiovascular disease and to the molecular mechanisms involved in Transcendental Meditation," said John Fagan, professor of molecular biology at Maharishi University of Management and senior author on the study.

Source:Plos one

Suffering With Arthritis? Do Yoga to Soothe Your Aching Joints and Get Instant Relief

The randomized trial of people with two common forms of arthritis has found that yoga can be safe and effective for people with arthritis. Johns Hopkins researchers report that 8 weeks of yoga classes improved the physical and mental well-being of people with two common forms of arthritis, knee osteoarthritis and rheumatoid arthritis.

 There's a real surge of interest in yoga as a complementary therapy, with 1 in 10 people in the U.S. now practicing yoga to improve their health and fitness, says researcher Susan J. Bartlett, adding that yoga may be especially well suited to people with arthritis because it combines physical activity with potent stress management and relaxation techniques and focuses on respecting limitations that can change from day to day.

Arthritis, the leading cause of disability, affects 1 in 5 adults, most of whom are under 65 years of age. Without proper management, arthritis affects not only mobility, but also overall health and well-being, participation in valued activities, and quality of life. There is no cure for arthritis, but one important way to manage arthritis is to remain active.

Yet up to 90 percent of people with arthritis are less active than public health guidelines suggest, perhaps due to arthritis symptoms such as pain and stiffness, but also because they are unsure of how best to remain active.

The researchers have developed a checklist to make it easier for doctors to safely recommend yoga to their patients, says researcher Clifton O. Bingham, suggesting that people with arthritis who are considering yoga should talk with their doctors about which specific joints are of concern, and about modifications to poses. The study is published in the Journal of Rheumatology.

Source: ANI
 

Practicing Yoga can Improve a Man's Parenting Skills

New research suggests that practicing yoga, which can improve physical and mental health, may also help men become better fathers.

 The three-year study with 14 different groups of male inmates took place at Chelan County Regional Jail in Wenatchee, Washington. The program was advertised among the jail population. Volunteers, who had to be parents of young children and pass a security screening, were recruited. 

 "We would have a class on a specific topic, like child development or setting limits," said researcher Jennifer Crawford from Washington State University. "That would last about an hour, then a yoga instructor would come in and give a guided yoga class," Crawford noted. 

The results showed that inmates demonstrated being more aware and accepting of their vulnerability and responsiveness to children, among other benefits. The instructor started every class with a centering exercise, then taught simple sequences that focused on standing poses; more complicated poses were not used due to potential health issues among the inmates. 

Outside of the class setting, the inmates did journaling exercises such as writing about their own upbringing or ways they communicate with their children. "Yoga can be physically demanding, and the initial responses we got from the participants confirmed that," Crawford said. 

"I believe the yoga practice helped participants become ready to learn and increased their willingness to try new ideas, absorb new information and begin to apply these in their lives," Crawford noted. The study was published in the California Journal of Health Promotion.

Source: IANS
 

Low Levels of Vitamin D may Increase Stress Fracture Risk

Active individuals who enjoy participating in higher impact activities may need to maintain higher vitamin D levels to reduce their risk of stress fractures, report investigators in The Journal of Foot & Ankle Surgery, as vitamin D plays a crucial role in ensuring appropriate bone density.
 The role of vitamin D in the body has recently become a subject of increasing interest owing to its many physiologic effects throughout multiple organ systems. Vitamin D is an essential nutrient that can behave as a hormone. It is obtained through diet and through the skin when exposed to the sun's rays. It is essential for bone development and remodelling to ensure appropriate bone mass density. Low levels of vitamin D can lead to osteoporosis, osteomalacia, decreased bone mineral density, and risk of acute fracture.
 Investigators tested the serum concentration of 25(OH)D, which is used to determine vitamin D status, in patients with confirmed stress fractures. "By assessing the average serum vitamin D concentrations of people with stress fractures and comparing these with the current guidelines, we wanted to encourage a discussion regarding whether a higher concentration of serum vitamin D should be recommended for active individuals," explained lead investigator Jason R. Miller, DPM, FACFAS, Fellowship Director of the Pennsylvania Intensive Lower Extremity Fellowship, foot and ankle surgeon from Premier Orthopedics and Sports Medicine, in Malvern, Pennsylvania, and Fellow Member of the American College of Foot and Ankle Surgeons.

The investigators reviewed the medical records of patients who experienced lower extremity pain, with a suspected stress fracture, over a three-year period from August 2011 to July 2014. All patients had x-rays of the affected extremity and were then sent for magnetic resonance imaging (MRI) if no acute fracture had been seen, yet concern for the presence of a stress fracture remained based on the physical examination findings. Musculoskeletal radiologists independently reviewed all the MRI scans, and the investigators then confirmed the diagnosis of a stress fracture after a review of the images. 

The serum vitamin D level was recorded within three months of diagnosis for 53 (42.74%) of these patients. Using the standards recommended by the Vitamin D Council (sufficient range 40 to 80 ng/mL), more than 80% of these patients would have been classified as having insufficient or deficient vitamin D levels. According to the standards set by the Endocrine Society (sufficient range 30 to 100 ng/mL), over 50% had insufficient levels. 

"Based on these findings, we recommend a serum vitamin D level of at least 40 ng/mL to protect against stress fractures, especially for active individuals who enjoy participating in higher impact activities," explained Dr. Miller. "This correlates with an earlier study of 600 female Navy recruits who were found to have a twofold greater risk of stress fractures of the tibia and fibula with a vitamin D level of less than 20 ng/mL compared with females with concentrations above 40 ng/mL 

"However, vitamin D is not the sole predictor of a stress fracture and we recommend that individuals who regularly exercise or enjoy participating in higher impact activities should be advised on proper and gradual training regimens to reduce the risk of developing a stress fracture," he concluded. 

Source: Eurekalert
 

Aconitine in Traditional Chinese Medicine May Lead to Severe Poisoning

A Chinese woman was diagnosed with aconitine-induced cardiovascular symptoms and doctors warn that this natural ingredient may lead to severe poisoning. The report has been published in the Canadian Journal of Cardiology.

A 45-year-old Chinese woman was diagnosed with a severe heart-rhythm disorder, bidirectional ventricular tachycardia (BVT), associated with aconitine poisoning. BVT is a rare form of tachycardia (characterized by a resting heart rate over 100 beats per minute) and a distinct pattern of ECG waves on presentation. 

The patient's husband reported that she had drunk about 50 milliliters of a medicinal liquid about 30 minutes before she developed a sudden drop in blood pressure and then lost consciousness. The woman had no history of previous heart-rhythm problems and there was no family history of unexpected sudden death or fatal accidents. On examination she had a heart rate of 150 beats per minute and her blood pressure was 50/30. Her skin was cool, moist, and cyanotic. Treatment with the antiarrhythmic agents amiodarone, metoprolol, lidocaine, and potassium chloride was ineffective. An abdominal ultrasound showed marked gastric retention. A gastric tube was used to suction out the contents of her stomach. After two hours, the patient's BVT ceased and her circulation improved. 
Investigation revealed that the patient's blood was positive for aconitine, a substance produced by the Aconitum plant, also known as devil's helmet or monkshood. Although well-known for its highly toxic properties, aconitine is the primary ingredient of the traditional Chinese medicine known as Fuzi, a remedy made from the processed lateral roots of Aconitum carmichaeli Debx. It is widely distributed in the southwest provinces of China and is used in small doses for its anti-inflammatory and pain-relieving effects. 
"Management of potentially lethal ventricular tachyarrhythmia associated with aconitine poisoning presents a therapeutic challenge. In a previously published case, amiodarone was effective in suppressing the BVT. However, in our patient, both lidocaine and amiodarone were ineffective," explained lead author Zhong Yi, MD, PhD, of the Aerospace Center Hospital, Beijing, People's Republic of China. 
"The public should be warned of the risk of severe poisoning that can accompany traditional Chinese medicinal usage of Fuzi," Dr. Yi concluded. 
Commenting on the report, Dr. P. Timothy Pollak, of the Department of Medicine at the University of Calgary, Alberta, cautioned that "not all products of Mother Nature are free of harm. This case report reminds us that aconitine is not the only naturally derived substance that can cause potentially lethal ventricular tachyarrhythmias, including BVT. The report also demonstrates the human tendency to think that if a little is good, more must be better." 
Dr. Pollak advises clinicians to be aware of what their patients are taking and be prepared to discuss alternative remedies, at least at a basic level. "Dodging the discussion can only lend credibility to any patient suspicions that as a practitioner of Western medicine, you have been denied the secrets of alternative remedies or are hiding them for ulterior motives. This report serves as a timely illustration that alternative remedies do have implications for the practice of cardiology that cannot be ignored." 
Source: Eurekalert

 

Ancient Ayurvedic Prakriti Classification Has Genetic Roots: CCMB Director

A major breakthrough discovery has revealed that 'dosha prakriti' or phenotypic classification of traditional Indian medicine indeed has a genetic basis. Scientists at Center for Cellular and Molecular Biology (CCMB) in Hyderabad were finally able to link India's ancient wisdom with modern sciences.

 Ayurveda dates back to the ancient period, where it was practised as the main type of medical system in India. It has first originated in the 1,500 BC and had been in practice for thousand of years. Ayurvedic physicians believe that there are three doshas - Vata (related to space and air), Pitta (fire and water) and Kapha (water and earth). Each individual would have different levels of these doshas, hence the diversities.

 "Whether such phenotypic classification has any molecular basis has been a matter of debate. A few groups had found some correlation when they looked at one or two specific genes. However, the association with Prakriti classification was lacking," said Ch Mohan Rao, director of the Council of Scientific and Industrial Research (CSIR) and Center for Cellular and Molecular Biology (CCMB).

A team of researchers recruited 3,416 healthy males in the age group of 20-40 years. They were screened by a software called AyuSoft, developed by C-DAC. Their blood samples were collected, isolation of DNA and genomic studies were carried out.

"In all, 262 individuals were selected for analysis using one million genetic markers," said Dr K.Thangaraj, lead scientist of the study. The findings were published as a paper titled 'Genome-wide analysis correlates Ayurveda Prakriti' in the Journal Nature. 

"Interestingly, although we had individuals from different ancestries and communities, they all got classified into these three classifications. This was a sign that there was real science behind this Ayurvedic classification. This discovery will be beneficial to both Ayurveda and Allopathy practitioners. This work will eventually lead to establishing Ayurveda on a sound footing along with modern medicine," explained Rao. 

 Source:Desk News

Girl With Epilepsy Inspires People to Support Legalization of Medical Marijuana in Mexico

A Mexico girl suffering with epileptic seizures since childhood has shown remarkable improvement after using medicinal cannabis or marijuana for a month.

 Grace can finally sleep through the night without being awakened by one of her epileptic crises since the eight-year-old Mexican girl started taking cannabis-based medicine a month ago.
 Her parents have seen a marked improvement in their daughter's conditions since she became the first person authorized to take medicinal marijuana in October.

"Her reaction has been very good. Since she took the medicine, we noticed that she could sleep all night," her father, Raul Elizalde, said from the family's home in an upper-class neighborhood of the northern industrial hub of Monterrey.

"Her nocturnal epileptic crises have practically disappeared and she's sleeping very well. This was the main change that we saw," he said, as his wife fed Grace, who sat in a baby high chair, and her younger sister, Valentina in their living room.

Grace has become a symbol for those battling to break Mexico's prohibitionist laws against marijuana in a country that has endured a decade of drug cartel violence.

The girl's parents secured an exception to Mexico's laws after they won a court battle in August, forcing health authorities to grant them the right to obtain cannabidiol (CBD), a therapeutic oil. It was a first victory for those advocating for legalization.

The Supreme Court issued a historic ruling on November 4 that opened the door to the legalization of marijuana by authorizing four people to grow and consume cannabis for their personal, recreational use.

Days later, Senator Cristina Diaz, a member of the ruling Institutional Revolutionary Party (PRI), introduced a measure that would allow imports and consumption of medical marijuana, saying it would benefit 5,000 Mexicans.

While President Enrique Pena Nieto has reiterated his opposition to legalization, he suggested that his government could change its mind depending on the outcome of a debate of experts in the coming months.

Other countries in the region are moving faster. More than 20 US states authorize medical marijuana while Colombia said last week that it would do the same. Chile's Congress is debating whether to legalize the drug while Uruguay has done so already.

Opinion polls show that a majority of Mexicans oppose legalization, though a survey by El Universal newspaper this month showed that 79 percent back the drug's use for medicinal purposes.

The national discussion has raised hopes among people like Grace's parents, who believe that medical marijuana can improve the quality of life of patients after other traditional medicine has failed.

Tastes like chocolate
Grace has Lennox-Gastaut syndrome, which caused her to have as many as 400 epileptic fits per day. She moves in a wheelchair and her parents feed her.

On a recent day, her mother, Mayela Benavides, squeezed the chocolate and mint flavored oil into Grace's mouth as her daughter sat in her baby chair.

"We tried other medicine which tasted terrible. The good thing about CBD is that it tastes good," said Benavides, an engineer.

The medicine is not a cure, but the goal is to reduce the number and intensity of seizures that Grace endures. The drug costs $250 for 100 milliliters, a small fortune for Mexico but which her parents can afford. 

She still experiences seizures. As she sat in her high chair, Grace suddenly started shaking, closed her big brown eyes and tightly squeezed her mother's hand for a couple of minutes. Her body finally relaxed and Mayela wiped her mouth.

"She just had one of her crises. But the crises that she's had in the mornings all her life are changing. They're less intense and less frequent. We're on the right path," Mayela said, writing the hour and duration of the latest seizure.

Vote this year?
Doctors told the parents that it would take two months for changes to be really noticeable and that her dose could be increased.

Senator Diaz, who is also from Monterrey, said she hoped that her bill will be approved before the end of the year. Colleagues from other parties are backing it, she said.

"We are only talking about imports of medicine, not eliminating the ban on making them in the national territory. But it's a first step. For children like Grace and many other people, improving their quality of life is urgent" said Diaz. 

Source: AFP

 

Traditional Chinese Medicine Improves Quality of Life for Cancer Patients

Traditional chinese medicine has evolved over thousands of years. A meta-analysis of dozens of studies of traditional Chinese medicine such as acupuncture and therapeutic massage, were observed to reduce gastrointestinal disruptions after surgery, and acupuncture was also found to lessen fatigue in cancer patients. The study was reported in Oncotarget.

 Dr. Qiang (Quentin) Liu said, "We think this is the most comprehensive study of traditional Chinese medicine psycho-behavioral interventions and the quality of life of cancer patients published to date. Our findings will promote more investigations into how the body and mind are connected during disease development, and will facilitate better cancer treatments." 

 Other interventions not associated with traditional Chinese medicine, including stress management, cognitive behavioral therapy and physical training, also were found to improve quality of life in Chinese cancer patients, the researchers report. 

The team started with 6,500 studies published in journals in China and 23,000 studies from Western journals. All of the research focused on nonpharmacological interventions involving adult Chinese cancer patients in China. After eliminating duplicate studies, those with nonstandard measures and those that failed to include control subjects or large enough sample sizes, the team ended up with a total of 67 studies, with 16 of them focused on traditional Chinese medicine. 

Keith Kelly said, "The latter 16 studies did not include enough studies of tai chi and qigong to allow the researchers to come to meaningful conclusions about the specific effects of those interventions. The total number of cancer patients included in the analysis was 6,806." 

The researchers said, "We were surprised by the limited number of papers on the use of traditional Chinese medicine psycho-behavioral interventions for Chinese cancer patients that qualified for entry into this meta-analysis, particularly since the TCMs originated and are mostly practiced in China." 

Kelly said, "Traditional Chinese medicine has been practiced for 2,500 years in China. But what is the scientific evidence that it improves quality of life in cancer patients? This paper establishes that it does. Unfortunately, we were not able to determine what specific components of traditional Chinese medicine are the most effective. I hope the evidence that traditional Chinese medicine and other nonpharmacological interventions benefit cancer patients will prompt new interest in research aimed at understanding the physiological mechanisms at play." 

Source: Eurekalert

 

Chronic Lymphocytic Leukemia Mutations Uncovered New Uses of Existing Cancer Drugs

Mining the DNA of chronic lymphocytic leukemia (CLL) patients uncovered 12 mutations that may be targetable using therapies already available for other cancers, revealed Penn Medicine researchers.

 The team, led by Anthony Mato, an assistant professor of Hematology/Oncology in the Perelman School of Medicine at the University of Pennsylvania and Penn's Abramson Cancer Center (ACC), and director of the Center for CLL, used next generation sequencing - tests developed by and run at Penn's Center for Personalized Diagnostics - to take a deeper dive into 87 CLL patients' genetic makeup. They captured a slew of mutations known to be associated with other cancers: ATM, TP53, BRAF and KRAS, to name a few. 

 Today, there are several already available drugs - PARP and BRAF inhibitors, for example - that target many of these mutations, but they are US Food and Drug Administration-approved to treat ovarian, prostate and skin cancers, not CLL. 

Mato said, "About 80% of the patients in the study had at least one mutation, and many of them are clinically actionable in other cancers. It's very likely that these same mutations may be targetable in CLL - which would open up a door for much-needed treatments for patients who fail therapies. These results set the stage for future CLL clinical trials to investigate this precision medicine approach, one that selects therapies already available in practice based on a patient's genetic profile." 

Patients in the study were treated with ibrutinib, a kinase inhibitor approved by the FDA in early 2014 for CLL patients who had received at least one prior therapy, or in combination with chemo-immunotherapy (CIT). Ibrutinib has shown promising response rates; however, approximately 30% of patients do not respond to the treatment and the therapy invariably leads to drug resistance. 

Researchers, including Abramson Cancer physicians Edward Stadtmauer, chief of Hematologic Malignancies and a professor of Hematology/Oncology, Stephen Schuster, the Robert and Margarita Louis-Dreyfus Associate Professor in Chronic Lymphocytic Leukemia and Lymphoma Clinical Care and Research, sequenced the tumors of 87 patients and analyzed clinical characteristics, genetic mutations and progression free survival. Jie Wang, a fellow in the division of Hematology/Oncology, will present the abstract on Sunday. 

The median age was 65.7 years old, 69% were men, and 23% received CIT alone, 20% received ibrutinib, and 27% received both CIT and Ibrutinib. The most frequently mutated genes among the study participants were ATM (15%), SF3B1 (12%), NOTCH1 (9%), DNMT3A (5%), and TP53 (9%). 

The presence of a pathogenic mutation - 19 in total - also predicted worse progression free survival in the patients receiving CIT compared to those without a pathogenic mutation. This was true even when controlling for certain cytogenetic mutations that are known to portend a poorer prognosis, the researchers found. 

CLL is a clinically and biologically heterogeneous disease that is commonly evaluated with fluorescence in situ hybridization (FISH), which screens for specific chromosomal and genetic abnormalities, like del17p in CLL patients, which is known to be associated with decreased survival. 

Wang said, "Next generation sequencing is an important additional tool that could further define genetic alterations that may be working in concert to drive malignancy and identify pathways that could be targeted with novel approaches." 

The CPD is a joint initiative between Penn Medicine's Department of Pathology and Laboratory Medicine and the ACC to support precision medicine at Penn. Since the launch of operations in February 2013, it has performed more than 4,000 advanced diagnostics on patients with a wide range of new and relapsed cancers. 

Source: Eurekalert

 

World’s First Dengue Vaccine Approved by Mexico

The dengue vaccine Dengvaxia, manufactured by Sanofi, has been approved by Mexico for prevention of the deadly mosquito-borne disease. This approval makes it the first vaccine in the world to prevent dengue, thereby bringing fruit to the 20-year effort of the drug company to produce the vaccine. It marks a major advance in medicine, with dengue joining the list of vaccine-preventable diseases.

Dengue has assumed endemic proportions in several parts of the world, claiming a huge number of lives every year. It is no longer limited to the tropics, but has spread far and wide to other regions as well. The virus that causes dengue spreads through the bite of the Aedes aegypti mosquito. The fever results in symptoms of severe joint and muscle pains. Several patients succumb to complications like shock or dengue hemorrhagic fever. With no definite antiviral treatment available against the virus as yet, a vaccine currently seems to offer the best option to deal with the infection. 

 The Dengvaxia vaccine has been approved by Mexico's Federal Commission for the Protection against Sanitary Risk for the prevention of dengue for people ranging from 9 to 45 years. 

Since a vaccine is administered to people who are healthy, it is important that besides being effective, it should not cause any side effects. The vaccine has been found to be safe in large clinical trials prior to its approval. It provides protection against all 4 variants of the dengue virus. Though it has not found to be 100% effective, it will hopefully reduce the number of affected people and thereby the transmission of the infection. 

The approval for the dengue vaccine in Mexico will hopefully be a major boost to the global efforts involved in the prevention of dengue. 
 News Desk

Researchers Identify 30 Key Genes for Longer, Healthier Life

Researchers have zeroed in on 30 genes which, if tweaked a bit, can get you eternal youth - without having to search for and drink that elusive elixir of life. The team revealed that one of these genes proved to be particularly influential - the bcat-1 gene.

 Michael Ristow, professor of energy metabolism at the Swiss Federal Institute of Technology in Zurich (ETH Zurich), said, "When we blocked the effect of this gene, it significantly extended the mean lifespan of the nematode by up to 25%." 

‘One of the 30 genes that have been identified - namely the bcat-1 gene - proved to be particularly influential in extending the mean lifespan of a nematode by up to 25%. The findings could influence how age-related diseases such as diabetes or high blood pressure could be prevented.’

Ristow has no doubt that the same mechanism occurs in humans. He said, "We looked only for the genes that are conserved in evolution and, therefore, exist in all organisms, including humans." 

The bcat-1 gene carries the code for the enzyme of the same name which degrades so-called branched-chain amino acids that naturally occurs in food protein building blocks. 

When the researchers inhibited the gene activity of bcat-1, the branched-chain amino acids accumulated in the tissue, triggering a molecular signalling cascade that increased longevity in the nematodes. Moreover, the time span during which the worms remained healthy was extended. 

The study that involved researchers from JenAge consortium from Jena in Zurich said, "As a measure of vitality, the researchers measured the accumulation of aging pigments, the speed at which the creatures moved, and how often the nematodes successfully reproduced. All of these parameters improved when the scientists inhibited the activity of the bcat-1 gene." 

In order to detect these genes, the researchers combed through 40,000 genes in the nematode C. elegans, zebra fish and mice. The multiple branched-chain amino acids are already being used to treat liver damage and are also added to sport nutrition products. 

The authors said, "However, the point is not for people to grow even older, but rather to stay healthy for longer." 

The study, published in the Nature Communication, will deliver important indicators on how the aging process could be influenced and how age-related diseases such as diabetes or high blood pressure could be prevented.

Source: IANS