Blogs bring new era to medicine

An expectant mother was due to deliver soon at the hospital, and her doctor found out that she was still a virgin, reads a post micro-blogged by her doctor.
Doctor Zhang Rongya at the renowned Peking Union Medical College Hospital posted the case on Jan 6 at Sina Weibo, one of China's most popular micro-blogging websites.
Zhang noted in the post that coitus interruptus (withdrawal) is not reliable in preventing pregnancy.
The entry received a lot of attention and has been forwarded by online readers nearly 15,000 times.
Among the more than 3,400 comments left by viewers, there were exclamations - and also accusations against Zhang who has about 70,000 followers, saying that the post was a potential breach of patient privacy.
With many useful tips like how to scientifically feed a baby and how to cope with postpartum depression, her micro-blogging site is among the most popular maintained by medical workers.
Zhang is among hundreds of Chinese medical workers who have taken up micro-blogging on the mainland.
There is no official count of the number of physicians using the Sina micro blog site, but doctors treating chronic diseases and cancer are among the most popular at the site, said Li Na, an editor in the health news department of Sina, which is in charge of the routine maintenance and management of health-related micro blogs.
"The popularity of a physician on a micro blog is largely decided by his or her communication skills, and very active users are usually relatively young, like doctor Zhang," she said.
Li said that among all their medical worker users, 50 percent had registered on their own while others were invited by the website.
Gu Zhongyi, a dietitian at the Beijing Friendship Hospital who has been using the Sina micro blog for more than a year, told China Daily that he was happy having more than 270,000 followers.
"Micro-blogging has helped substantially improve the doctor-patient relationship through enhanced mutual understanding and in my case, it also served as a useful tool helping to schedule patients' visits," he said.
Zeng Xiaopeng, deputy director of the Beijing Centers for Disease Control and Prevention, who micro-blogs at Sohu, another major micro-blogging service provider on the mainland, said: "I constantly write micro-blog posts to spread knowledge such as ways to keep bugs out of the house. My fans can read the blog and leave their questions, which I can answer later."
He has now nearly 22,600 fans on his Sohu micro blog.
"The micro blog facilitates more interactive communication between me and the public, which is quite different from health seminars only attended by professionals," he said.
At the Sohu micro blog, the number of registered doctors exceeds 200, coming from various disciplines from pediatrics to stomatology.
"The number has kept rising," said Yu Haitao, an employee at the Sohu micro blog.
"Based on our rough calculations, most of our doctor users are about 50 years old and have extensive experience in health promotion and education," he said.
"They are extremely cautious not to reveal any private information about their patients and so far we have not received any complaints concerning the doctors' blogging," he added.
Concerns persist
However, many experts still worry about the potential risks and challenges surrounding doctors' blogging, and they urge proper guidance and management.
"Privacy is one major concern. Another is that doctors may use the mass communication tools to promote certain medicines and hospitals," said Ding Junjie, a professor with the Communication University of China.
"Although we already have strict rules regulating such advertisements in traditional media, we have no such rules for micro blog use," he said.
So far, there are no evidence-based guidelines or regulations to guide medical professionals on the use of social media in general.
Potential challenges from medical micro-blogging are not unique to China.
According to a US survey published in 2009 in the Journal of the American Medical Association, 60 percent of the medical school deans polled reported incidents by their students involving unprofessional postings on various social networking sites.
Some 13 percent admitted to incidents that violated patient privacy, it said.
Regarding doctor Zhang and the virgin birth, "that was a bit inappropriate and might cause lawsuits", Chen Wei, a lawyer from the Yingke Law Firm in Beijing, told China Daily.
"If she mentioned clearly that the woman was one of her patients, others might easily track her, which might be against her will and cause her trouble," she explained.
In such a case, the patient could sue the doctor for violation of privacy, she said.
Also, posting photos of patients, even without showing the face, is risky, she added.
"Platforms like micro blogs are actually powerful public forums and doctors should use them with caution," she said.
Ding agreed, though he said that he recognized the merits of doctors' micro-blogging activity.
"Since quality medical resources are limited, micro-blogging as a means to relieve the ever-increasing pressure on public hospitals could be a good alternative," he said.
For example, Liu Weizhong, health bureau chief of Gansu province, pioneered in getting more than 10,000 local veteran doctors to micro-blog, which helps the public with scientific know-how and disease prevention knowledge.
"That would surely benefit people, but it could not replace seeing a doctor at a hospital," Liu said.
Ding agreed, saying: "What we need is just a little more regulation, for example restricting qualification evaluations on doctors' micro blogs".
Solutions developing
On Jan 10, Deng Haihua, spokesman of the Ministry of Health, said: "We've noticed that a rising number of health-related micro blogs were well-received by the general public."
However, "management and supervision over them have to be strengthened", he noted.
Despite a lack of related laws and regulations, the ministry takes the basic view that doctors could not practice medicine on a micro blog, he stressed.
Ma Changsheng, a cardiologist at Anzhen Hospital in Beijing, however, thought otherwise.
"Even if it's not exactly on a micro blog, online health service represents a trend. Most patients don't actually need to come to the hospital", he said.
"A regulated, fee-charging online service might be a good way to make medical resources more efficient," he said.
Last week, the Beijing health bureau convened its first meeting on micro-blogging by doctors and hospitals.
According to an employee surnamed Chen from the Peking Union Medical College Hospital's information office, who attended the meeting, the capital health authorities generally encourage medical micro-blogging.
"But they are at the same time mulling over guidelines and regulations", she said.
At the Peking Union hospital, self-management and supervision has already begun, she noted.
She said that since May, the hospital has assigned special staff to maintain and update the hospital's official micro blog and follow micro blogs, especially by active doctors.
Unprofessional conduct such as breaching patient privacy and making a diagnosis is prohibited on micro blogs, she said.
"Given that it's a new phenomenon we are still groping for better use of the platform," she added.
Source:China Daily

Mission to India breaks educational barriers: Ayurvedic medicine to be taught at UWI

Professor Clement Sankat, pro vice-chancellor and campus principal of The University of the West Indies (UWI), St Augustine Campus, and the director of Institutional Advancement and Internationalisation, Sharan C Singh, are currently in India on a ten-day mission in partnership with the delegation led by the Prime Minister Kamla Persad-Bissessar comprising other tertiary institutions, public and private organisations with interests in Indian partnerships. The purpose of this mission is for the regional UWI to deepen and strengthen the institution’s collaboration with Indian higher education institutions to build capacity and enhance competitiveness. The UWI team recently completed three intensive days of meetings in New Delhi with some of India’s leading universities and research institutions, including the world famous Indian Institute of Technology (Delhi), the Indira Gandhi National Open University (India’s largest open university), Jawaharlal Nehru University, the All India Institute of Medical Sciences (India’s premier medical school), the National University of Education Planning and Administration, The Energy Resource Institute (a leading alternative energy research and training institution), the Agricultural Scientists Research Board and the Shriram Institute (the country’s leading industrial research institute).
The meetings in New Delhi produced a number of tangible positive outcomes, such as the setting up of demonstration laboratories at The UWI in the near future, and the three days culminated with the signing of a Memorandum of Understanding with the Government of India through its Department of AYUSH on January 6 for provision of a Professor in Ayurveda to The UWI. The signing took place at New Delhi’s famous Hyderabad House, which hosts most visiting Heads of State to India, and was done in the presence of Prime Minister Manmohan Singh of India, Prime Minister Persad-Bissessar, government ministers and other senior officials from both countries. This agreement falls under the umbrella of a government-to-government agreement for provision of technical assistance between both countries and results from months of negotiation involving the Indian High Commission in Trinidad, the Government of Trinidad and Tobago, The UWI and related agencies. AYUSH is the governing body for Ayurveda under India’s Ministry of Health and Family Welfare and the National Institute of Ayurveda is India’s most prestigious Ayurveda institute. The provision of this Chair in Ayurveda to The UWI comes under a programme where the Government of India provides expertise and technical assistance to countries around the world to conduct research and training in this 4,000-year-old discipline of holistic medicine.
According to 2010 figures from the Department of AYUSH in India, there are approximately 478,750 registered Ayurveda practitioners and 2,458 hospitals with 44,820 beds. In terms of the educational aspect of the industry, there are approximately 256 Ayurveda colleges and 66 postgraduate colleges, with the National Institute of Ayurveda in Jaipur being the apex body amongst them. What is most interesting, however, is the vast commercial enterprise that supports India’s massive Ayurveda system. Ayurveda products can be found in almost every pharmacy, grocery and parlour, from large commercial cities to small remote villages. The historical and contemporary experience of India demonstrates the distinct possibilities for the commercialisation of natural products from the Caribbean, especially given the rich tropical plant diversity in the region and its location as a gateway to North, Central and South America where natural remedies are increasingly in high demand, especially with respect to addressing lifestyle diseases, many of which currently also challenge the population of the Caribbean. Following the signing of the MoU, Persad-Bissessar took the opportunity of being in Jaipur, where she is being honoured at the Pravasi Bharatiya Divas, to visit the National Institute of Ayurveda. Accompanying her were various Ministers, including the Minister of Science, Technology and Tertiary Education, Fazal Karim, and the UWI team. During the visit, the Joint Secretary of AYUSH and the director of the Institute provided an enlightened perspective on the discipline, the global industry and opportunities for the Caribbean. A comprehensive tour of the Campus, which includes a 500-bed teaching hospital for undergraduate and postgraduate teaching was conducted. Facilities also included the national repository for natural products, a manufacturing facility and a field station for the propagation of medicinal plants.

Partner's 'Viral Load' a Major Factor in HIV Transmission: Study

The level of the HIV-1 virus in the blood of an HIV-infected person is the single most important risk factor for sexual transmission of HIV to an uninfected partner, a new study of heterosexual couples has found.
The research, published online Jan. 12 in The Journal of Infectious Diseases, also confirmed that the use of condoms significantly reduces the risk of transmission of HIV, the virus that causes AIDS.
Researchers studied nearly 3,300 HIV-discordant couples (one partner has HIV and the other is HIV-free) in sub-Saharan Africa and found that the average rate of HIV-1 transmission was about one per 900 acts of sexual intercourse.
The level of HIV-1 RNA in the blood of the infected partner was the most important factor in HIV transmission. The higher the viral load in the infected partner, the higher the risk of transmission. This finding highlights the importance of lowering viral load in order to reduce the spread of HIV-1 through sex, the researchers said in a news release from the Infectious Diseases Society of America.
The investigators also found that older age was associated with a reduced rate of HIV transmission and that male circumcision reduced female-to-male transmission by about 47 percent. However, genital herpes infections and genital ulcers were associated with increased transmission rates.
Condom use reduced the risk of HIV transmission by 78 percent, according to James Hughes of the University of Washington in Seattle and colleagues there and in Africa.
"Our results underscore the importance of antiretroviral therapy and, possibly, treatment of co-infections, to reduce plasma HIV-1 viral load in HIV-1 infected partners, and condom promotion, male circumcision, and treatment of symptomatic sexually transmitted infections for HIV-1 uninfected partners as potential interventions to reduce HIV-1 transmission," the researchers concluded in their report.
More information
The U.S. Centers for Disease Control and Prevention has more about HIV transmission.

Science's "most beautiful theories"

From Darwinian evolution to the idea that personality is largely shaped by chance, the favorite theories of the world's most eminent thinkers are as eclectic as science itself.
Every January, John Brockman, the impresario and literary agent who presides over the online salon Edge.org, asks his circle of scientists, digerati and humanities scholars to tackle one question.
In previous years, they have included "how is the Internet changing the way you think?" and "what is the most important invention in the last 2,000 years?"
This year, he posed the open-ended question "what is your favorite deep, elegant or beautiful explanation?"
The responses, released at midnight on Sunday, provide a crash course in science both well known and far out-of-the-box, as admired by the likes of Astronomer Royal Martin Rees, physicist Freeman Dyson and evolutionary biologist Richard Dawkins.
Several of the nearly 200 scholars nominated what are arguably the two most powerful scientific theories ever developed. "Darwin's natural selection wins hands down," argues Dawkins, emeritus professor at Oxford University.
"Never in the field of human comprehension were so many facts explained by assuming so few," he says of the theory that encompasses everything about life, based on the idea of natural selection operating on random genetic mutations.
Einstein's theory of relativity, which explains gravity as the curvature of space, also gets a few nods.
As theoretical physicist Steve Giddings of the University of California, Santa Barbara, writes, "This central idea has shaped our ideas of modern cosmology (and) given us the image of the expanding universe."
General relativity explains black holes, the bending of light and "even offers a possible explanation of the origin of our Universe - as quantum tunneling from 'nothing,'" he writes.
Many of the nominated ideas, however, won't be found in science courses taught in high school or even college.
Terrence Sejnowski, a computational neuroscientist at the Salk Institute, extols the discovery that the conscious, deliberative mind is not the author of important decisions such as what work people do and who they marry. Instead, he writes, "an ancient brain system called the basal ganglia, brain circuits that consciousness cannot access," pull the strings.
Running on the neurochemical dopamine, they predict how rewarding a choice will be - if I pick this apartment, how happy will I be? - "evaluate the current state of the entire cortex and inform the brain about the best course of action," explains Sejnowski. Only later do people construct an explanation of their choices, he said in an interview, convincing themselves incorrectly that volition and logic were responsible.
To neuroscientist Robert Sapolsky of Stanford University, the most beautiful idea is emergence, in which complex phenomena almost magically come into being from extremely simple components.
For instance, a human being arises from a few thousand genes. The intelligence of an ant colony - labor specialization, intricate underground nests - emerges from the seemingly senseless behavior of thousands of individual ants.
"Critically, there's no blueprint or central source of command," says Sapolsky. Each individual ant has a simple algorithm for interacting with the environment, "and out of this emerges a highly efficient colony."
Among other tricks, the colony has solved the notorious Traveling Salesman problem, or the challenge of stopping at a long list of destinations by the shortest route possible.
THE OTHER PAVLOVIAN EFFECT
Stephen Kosslyn, director of the Center for Advanced Study in the Behavioral Sciences at Stanford, is most impressed by Pavlovian conditioning, in which a neutral stimulus such as a sound comes to be associated with a reward, such as food, producing a response, such as salivation.
That much is familiar. Less well known is that Pavlovian conditioning might account for placebo effects. After people have used analgesics such as ibuprofen or aspirin many times, the drugs begin to have effects before their active ingredients kick in.
From previous experience, the mere act of taking the pill has become like Pavlov's bell was for his dogs, causing them to salivate: the "conditioned stimulus" of merely seeing the pill "triggers the pain-relieving processes invoked by the medicine itself," explains Kosslyn.
Science theories that explain puzzling human behavior or the inner workings of the universe were also particular favorites of the Edge contributors:
* Psychologist Alison Gopnik of the University of California, Berkeley, is partial to one that accounts for why teenagers are so restless, reckless and emotional. Two brain systems, an emotional motivational system and a cognitive control system, have fallen out of sync, she explains.
The control system that inhibits impulses and allows you to delay gratification kicks in later than it did in past generations, but the motivational system is kicking in earlier and earlier.
The result: "A striking number of young adults who are enormously smart and knowledgeable but directionless, who are enthusiastic and exuberant but unable to commit to a particular work or a particular love until well into their twenties or thirties."
BEAUTIFUL IDEAS
* Neurobiologist Sam Barondes of the University of California, San Francisco, nominates the idea that personality is largely shaped by chance. One serendipitous force is which parental genes happen to be in the egg and sperm that produced the child.
"But there is also chance in how neurodevelopmental processes unfold - a little virus here, an intrauterine event there, and you have chance all over the place," he said in an interview. Another toss of the dice: how a parent will respond to a child's genetic disposition to be outgoing, neurotic, open to new experience and the like, either reinforcing the innate tendencies or countering them.
The role of chance in creating differences between people has moral consequences, says Barondes, "promoting understanding and compassion for the wide range of people with whom we share our lives."
* Timothy Wilson nominates the idea that "people become what they do." While people's behavior arises from their character - someone returns a lost wallet because she is honest - "the reverse also holds," says the University of Virginia psychologist. If we return a lost wallet, our assessment of how honest we are rises through what he calls "self-inference." One implication of this phenomenon: "We should all heed Kurt Vonnegut's advice," Wilson says: "'We are what we pretend to be, so we must be careful about what we pretend to be.'"
* Psychologist David Myers of Hope College finds "group polarization" a beautiful idea, since it explains how interacting with others tends to amplify people's initial views. In particular, discussing issues with like-minded peers -increasingly the norm in the United States, where red states attract conservatives and blue states attract liberals - push people toward extremes. "The surprising thing is that the group as a whole becomes more extreme than its pre-discussion average," he said in an interview.
* Martin Rees, professor of cosmology and astrophysics at the University of Cambridge, nominates the "astonishing concept" that what we consider the universe "could be hugely more extensive" than what astronomers observe.
If true, the known cosmos may instead "be a tiny part of the aftermath of 'our' big bang, which is itself just one bang among a perhaps-infinite ensemble," Rees writes. Even more intriguing is that different physics might prevail in these different universes, so that "some of what we call 'laws of nature' may ... be local bylaws."
By: Sharon Begley
Source:YahooNews

Research Reveals Salt's Real Role in High Blood Pressure

The widely-believed concept that high blood pressure is the result of excess salt causing an increased blood volume, exerting extra pressure on the arteries has been debunked by researchers.
Their research found that excess salt stimulates the sympathetic nervous system to produce adrenalin, causing artery constriction and hypertension.The research was led by Irene Gavras, MD, and Haralambos Gavras, MD, both professors of medicine at Boston University School of Medicine.
"The purpose of this paper is to correct an erroneous concept that has prevailed for many years, even though scientific evidence has mounted against it," said Irene Gavras, who is also a physician in Boston Medical Center's Hypertension practice.
The term "volume-expanded hypertension" implies that excess salt leads to the retention of extra fluid within the arterial circulatory system, causing an increase in blood volume and added pressure on the arterial walls.
However, research has shown that conditions characterized by the expansion of blood volume from other causes, such as the secretion of antidiuretic hormone or the excessive elevation of blood sugar, do not cause a rise in blood pressure because the extra fluid is accommodated by the distention of capillaries and veins.
"The body's circulatory system is a highly flexible vascular system with the capacity to open up new capillaries and distend veins in order to accommodate increased fluid volume," said Irene Gavras, MD, professor of medicine at BUSM.
Through a review of numerous studies, the researchers demonstrated that the mechanism of hypertension resulting from the excessive consumption and retention of salt stimulates the sympathetic nervous system in the brain to increase adrenaline production.
The increased adrenalin being circulated throughout the body causes the arteries to constrict, which results in resistance to blood flow and a decrease in circulatory volume.
The over-activation of the sympathetic nervous system - part of the autonomic nervous system that helps maintain the body's homeostasis - has been recognized clinically as a characteristic of hypertension that accompanies renal failure, which is the most typical example of elevated blood pressure from excessive salt retention.
Diuretics, which remove excess salt, are widely used to treat this type of hypertension.
However, this study provides convincing evidence that the sympathetic nervous system should be the focus of further investigations into treatments for hypertension.
"The implication of our findings shows that the optimal treatment for hypertension, for cases associated with renal failure, should not only include diuretics but also the use of drugs that block the central sympathetic nervous system," concluded Irene Gavras.
The study was published online in the Journal of Hypertension.
Source-ANI

Global Warming Could be Reversed by Newly Discovered Particle

A particle that could "cool the planet" and naturally clean up the atmosphere has been discovered by scientists.According to researchers from The University of Manchester, The University of Bristol and Sandia National Laboratories, Criegee biradicals are invisible chemical intermediates and are powerful oxidisers of pollutants such as nitrogen dioxide and sulfur dioxide, produced by combustion.
Although these chemical intermediates were hypothesised in the 1950s, it is only now that they have been detected. Scientists now believe that, with further research, these species could play a major role in off-setting climate change.
The detection of the Criegee biradical and measurement of how fast it reacts was made possible by a unique apparatus, designed by Sandia researchers, that uses light from a third-generation synchrotron facility, at the Lawrence Berkeley National Laboratory's Advanced Light Source.
The intense, tunable light from the synchrotron allowed researchers to discern the formation and removal of different isomeric species - molecules that contain the same atoms but arranged in different combinations.
The researchers found that the Criegee biradicals react more rapidly than first thought and will accelerate the formation of sulphate and nitrate in the atmosphere. These compounds will lead to aerosol formation and ultimately to cloud formation with the potential to cool the planet.
Carl Percival, Reader in Atmospheric Chemistry at The University of Manchester and one of the authors of the paper, believes there could be significant research possibilities arising from the discovery of the Criegee biradicals.
"Criegee radicals have been impossible to measure until this work carried out at the Advanced Light Source. We have been able to quantify how fast Criegee radicals react for the first time," Percival said.
"Our results will have a significant impact on our understanding of the oxidising capacity of the atmosphere and have wide ranging implications for pollution and climate change.
"The main source of these Criegee biradicals does not depend on sunlight and so these processes take place throughout the day and night," he added.
The study has been published in Science.
Source-ANI

First Hepatitis E Vaccine Approved in China

The first hepatitis E vaccine has been developed and approved for use in China.
Hepatitis E is a viral disease causing inflammation of the liver. In China, it is the most common type of hepatitis affecting adults. It is a waterborne disease and spreads through intake of food and water contaminated with feces. It often occurs in the form of epidemics. Poor sanitation is one of the main reasons for spread of hepatitis E.

Features of hepatitis E infection include jaundice, loss of appetite, an increase in the size of liver, pain in abdomen, nausea, vomiting and fever. The patient usually recovers without any treatment.

If the above is the case, then why do we need a vaccine against hepatitis E? We need the vaccine because of the large numbers of people affected during an epidemic, especially those living in compromised living conditions like refugee camps and serving the army. Hepatitis E can result in severe disease and death in some cases, and there is no specific treatment for it currently. Though there is no substitute for improving hygiene to prevent hepatitis E infection, the vaccine could provide temporary relief against hepatitis E in countries that would need more time to improve sanitation.
Though hepatitis E is relatively rare in developed countries, a vaccine may also be useful in these countries especially to travelers of endemic areas, or people at increased risk of developing hepatitis E infection like those with reduced immunity or chronic liver disease.
A vaccine against hepatitis E was tested earlier in the Nepalese army and was found to be relatively safe and effective.
The vaccine, HEV 239 that was just approved in China, was under development for 14 years. The vaccine was earlier tested in 97,356 healthy participants in China. The vaccine was administered in 3 doses. None of the patients treated with a complete course of the vaccine contacted hepatitis E infection within a year of taking the vaccine. The people administered the vaccine also did not suffer from any serious vaccine-associated side effects.
The vaccine will be administered to patients at high risk for developing hepatitis E infection. China will also work with international organizations to introduce the vaccine to other countries, according to a statement issued by China’s Ministry of Science and Technology.
Reference:
http://www.biospectrumasia.com/Content/120112CHN17943.asp?nl=[[forstats]]