Health24.com | SEE: Woman develops infection after rare flesh-eating bacteria invades her eye sockets

According to a case report published in the Journal of Emergency Medicine, a 58-year-old woman showed up at the emergency room after developing severe eye pain and swelling for more than five days.

The life-threatening infection is extremely rare, and the study’s co-author, Dr. Ryan Walsh, an assistant professor in the Department of Emergency Medicine at Vanderbilt University Medical Center in Tennessee, told Live Science that it’s “probably a once in a career case”.

Image: iStock

Image used in video: Image appears courtesy of Elsevier, Copyright Elsevier (2019).

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Men ‘at greater risk of infertility’ if small at birth

Poor growth in the womb could lead to problems linked to fertility – but only in men, a study says.

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Chemists’ calculations may advance cancer prediction

When do cancer-prone cells turn into full-blown cancer? A Rice University scientist and his colleague believe there’s a way to know.

It may become possible for biomarkers in blood to reveal whether mutated cells have turned a corner toward forming tumors, and how long the process — depending on the type of cancer — is likely to take. That could give patients a sense of the risk they face before they become ill.

Rice chemist Anatoly Kolomeisky, with postdoctoral research associate Hamid Teimouri and graduate alumna Maria Kochugaeva, directed their theoretical expertise in modeling random (stochastic) processes to the problem of why cancerous cells that are usually destroyed by the body’s immune system sometimes overcome a gauntlet of defenses to become tumors.

The study in Scientific Reports is intended to clarify microscopic aspects of cancer initiation, the point at which random mutations become “fixed” in cells, which pass them on and eventually overwhelm tissue.

As part of their study, the researchers calculated fixation probabilities for 28 types of cancer to see how they correlate with available clinical data on cancer lifetime risks — and found that correlation was anything but sure.

“The problem with cancer is that we’re detecting it too late,” said Kolomeisky, a professor of chemistry and chairman of the department in Rice’s Wiess School of Natural Sciences. The researchers argue their “convenient, simple and versatile” method to evaluate cancer initiation dynamics should incorporate initiation dynamics for specific cancer types as well as established lifetime risks.

Kolomeisky has a long track record of discovery related to cellular mechanisms, especially related to motor proteins that transport cargo in cells and genome editing. Inspired by an off-hand comment from a colleague that his calculations looked like they could relate to cancer, Kolomeisky set off to find out if his mathematical approach could be applied to cancer initiation dynamics.

Based on their formulas, the researchers developed a chart correlating lifetime risks and initiation times for 28 types of cancer — and found very little to connect the two. “It indicates that cancer lifetime risks alone cannot be utilized to evaluate the danger of getting cancer,” the researchers wrote, suggesting fixation times that indicate tumor initiation are a more important metric.

For example, the chart shows that colorectal adenocarcinoma with FAP carries the highest lifetime risk, but its fixation time of 15 years is nearly three times that of duodenum adenocarcinoma with FAP, which is thought to have a much lower lifetime risk. At the other end of the fixation scale are hepatocellular carcinomas, at more than 31,000 years.

Their calculations compared the “fitness” of individual cells with cancer-related mutations to normal cells without, and how fast they divided. Tissue with mutant cells that divided at a 1-to-1 ratio with normal cells were the slowest to “fix” tumors.

The researchers assumed mutant cells with a speed advantage would fix tumors faster, and they were right. But they were surprised when their models showed cells with disadvantageous mutations (slower-than-normal division) were also occasionally faster than normal cells to fix.

“People assume, usually subconsciously, that something more probable will happen faster,” Kolomeisky said. “But we found that is not the case for cancers. Doctors shouldn’t make decisions simply on lifetime risk, as is typically done, but also on the dynamics we calculated as our main results.

“The main points are that we can calculate, with a lot of assumptions, the average time before cancer will start,” he said. “We also argue that the probability of cancer does not typically correlate well with the time it starts. Something more probable is not necessarily fast.”

Mutant cells that release biomarkers to the bloodstream may provide a better way to spot precancerous conditions.

“In the future, this could become part of personalized medicine,” Kolomeisky said. “A doctor gives you a test and checks for the fraction of mutated cells in your tissues.

Then you can estimate how long it would take before the mutated cells will occupy the whole tissue. If it’s 100 years, you probably should not worry too much. But if it’s one year, then you might have to take drastic measures.”

He said the model will certainly improve as more relevant parameters are incorporated. But anything it produces now and in the future should not deter one from a healthy lifestyle.

“We’re not saying that you will or won’t get cancer no matter what you do,” Kolomeisky said. “Just that the probability is different. If you smoke, if you don’t eat well or don’t exercise, the probability will be higher.”

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Scientists discover key neural circuit regulating alcohol consumption

Scientists have known that a region of the brain called the central nucleus of the amygdala (CeA) plays a role in behaviors related to alcohol use and consumption in general. It’s been less known which precise populations of brain cells and their projections to other brain regions mediate these behaviors. Now, UNC School of Medicine scientists discovered that specific neurons in the CeA contribute to reward-like behaviors, alcohol consumption in particular.

Published in the Journal of Neuroscience, this research pinpoints a specific neural circuit that when altered caused animal models to drink less alcohol.

“The fact that these neurons promote reward-like behavior, that extremely low levels of alcohol consumption activate these cells, and that activation of these neurons drive alcohol drinking in animals without extensive prior drinking experience suggests that they may be important for early alcohol use and reward,” said senior author Zoe McElligott, PhD, assistant professor of psychiatry and pharmacology. “It’s our hope that by understanding the function of this circuit, we can better predict what happens in the brains of people who transition from casual alcohol use to subsequent abuse of alcohol, and the development of alcohol use disorders.”

McElligott, who is also a member of the UNC Bowles Center for Alcohol Studies, set out to investigate if a population of neurons that express a specific neuropeptide (neurotensin or NTS) contributes to reward-like behaviors and alcohol drinking. She was especially interested in these neurons in the context of inexperienced alcohol use, such as when a person first begins to drink alcohol. Also, NTS neurons are a subpopulation of other neurons in this CeA brain region that have been implicated in anxiety and fear — known as the somatostatin and corticotropin releasing factor neurons.

Using modern genetic and viral technologies in male mice, McElligott and colleagues found that selectively lesioning or ablating the NTS neurons in the CeA, while maintaining other types of CeA neurons, would cause the animals to drink less alcohol. This manipulation did not alter anxiety-like behavior. It also did not affect the consumption of other palatable liquids such as sucrose, saccharin, and bitter quinine solutions.

“We found that these NTS neurons in the CeA send a strong projection to the hindbrain, where they inhibit the parabrachial nucleus, near the brainstem,” McElligott said.

Using optogenetics — a technique where light activates these neurons — the researchers stimulated the terminal projections of the CeA-NTS neurons in the parabrachial and found that this stimulation inhibited the neurons in the parabrachial. When the scientists stimulated this projection with a laser in one half of the animal’s box, animals would spend more time where the stimulation would occur.

Animals also learned to perform a task to get the laser stimulation to turn on, and they would do this repeatedly, suggesting that they found this stimulation to be rewarding.

“Furthermore, when we stimulated this projection, animals would drink more alcohol as compared to when they had an opportunity to drink alcohol without laser stimulation,” McElligott said. “In contrast to our study where we ablated the NTS neurons, laser stimulation of this parabrachial pathway also caused the animals to consume caloric and non-caloric sweetened beverages. When the animals were presented with regular food and a sweet food, however, laser stimulation did not enhance the consumption regardless of the mouse’s hunger state. This suggests that different circuits may regulate the consumption of rewarding fluids and solids.”

McElligott and her graduate student María Luisa Torruella Suarez, the first author of this study, hope to explore how alcohol experience may change these neurons over time.

“Would these cells respond differently after animals have been drinking high quantities of alcohol over time?” McElligott said. “We also want to discover which populations of neurons in the parabrachial are receiving inputs from these neurons. Fully understanding this circuit could be the key to developing therapeutics to help people with alcohol use disorders.”

The National Institutes of Health, The North Carolina Translational Clinical Science (NC TraCS) Institute, the Alcohol Beverage Medical Research Foundation, and The UNC Bowles Center for Alcohol Studies funded this research.

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Deforestation, erosion exacerbate mercury spikes near Peruvian gold mining

Scientists from Duke University have developed a model that can predict the amount of mercury being released into a local ecosystem by deforestation and small-scale gold mining.

The research, which appears online on December 11 in the journal Environmental Science and Technology, could point toward ways to mitigate the worst effects of mercury poisoning in regions such as those that are already experiencing elevated mercury levels caused by gold mining.

“We’ve taken a lot of ground measurements in the Peruvian Amazon of mercury levels in the water, soil and fish,” said Heileen Hsu-Kim, professor of civil and environmental engineering at Duke University. “But many areas in the Amazon aren’t easily accessible, and the government often does not have the resources needed to test local sites.”

“When you clear the land for mining, it leaves behind a landscape that basically went from lush greenery to barren desert,” said Hsu-Kim. “You can easily see the effects in satellite images. If (governments) could use publicly available satellite imagery to identify areas that are likely to be contaminated, it could help them make informed policy decisions to protect public health.”

The past two decades have seen a sharp increase in illegal and informal gold mining in Peru’s southern Amazon region of Madre de Dios. These small-scale operations typically involve cutting down all of the trees in a particular area, digging a large pit and then using mercury to extract gold from the excavated soil.

After larger, coarse particles are separated, the remaining fine soil is combined with water and mercury inside a large drum much like an oil barrel, and shaken. The mercury binds to any gold in the soil, creating a large chunk that can be easily removed. This chunk is then burned, evaporating and releasing the mercury into the air while leaving behind pure gold.

Besides releasing mercury into the atmosphere, miners typically add three to four times more mercury to each barrel than is actually needed, says Hsu-Kim. While this ensures all of the gold is extracted, it also means there is a large amount of leftover mercury in the slurry that is inevitably dumped back into the excavated pit.

And because the whole process started with the clearing of trees, there’s nothing to stop the mercury-laden soil from eroding into nearby rivers.

“While the local mercury levels might only double due to the mining itself, the effect of the erosion creates a four-fold increase in the amount of mercury being released into local rivers,” said Hsu-Kim.

“This means mining practices can hit people three times with mercury — once from direct contact, once from atmospheric transport and deposition, and once from soil mercury mobilization due to land clearing,” said William Pan, the Elizabeth Brooks Reid and Whitelaw Reid Associate Professor of Population Studies at Duke. “The scenarios we run demonstrate that even if mining were to end today, since vegetation is unlikely to return for several decades, the cleared land will continue to release mercury.”

Hsu-Kim and Pan worked with graduate students Sarah Diringer and Axel Berky to build a model to predict the amount of mercury and other contaminants being released into rivers. It combines data from a watershed erosion model, local variables such as annual rainfall, landscape and soil types, and data gathered about deforestation from satellite imagery.

When they analyzed mercury content in samples of soil and water from nine locations in the Colorado River watershed in Madre de Dios, they found that their model accurately predicted which areas were likely to have higher water concentrations of mercury.

The model suggests that over the last two decades, deforestation has doubled the amount of mercury entering local water sources in the Colorado River watershed, and increased it four-fold in the Puquiri subwatershed. Their model also suggests that if the current trends of deforestation continue, the amount of mercury being released into the local river systems may increase by 20 to 25 percent by 2030.

While the findings may sound bleak, the fact that the model works does offer some light at the end of the tunnel.

“We have shared our model with the Peruvian Ministry of Environment and Ministry of Health,” Pan said. “We are working with them to evaluate whether our approach can be used as a tool for developing new policies regarding mining, environmental monitoring of mercury and human exposure.”

Story Source:

Materials provided by Duke University. Original written by Ken Kingery. Note: Content may be edited for style and length.

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Health24.com | HIV med tied to too-small heads in newborns

Children born to women who take the HIV drug efavirenz during pregnancy have a higher risk of small head size – a birth defect known as microcephaly – compared to babies exposed to other HIV drugs in the womb, new research shows.

Prenatal exposure to the drug was also linked to developmental delays in children.

Limited impact of findings

But one US expert said the new data shouldn’t alarm most HIV-positive women.

“Efavirenz has not been widely used in the US during pregnancy for many years due to its association with neural tube defects in studies conducted in monkeys,” said Dr Joseph McGowan, medical director of the Northwell Health HIV Service Line Program in Manhasset, New York.

“Antiretroviral usage patterns have shifted away from efavirenz as recommended therapy, so the impact of these findings in the US and developed countries may be limited,” said McGowan, who wasn’t involved in the new study.

“The major take-home from this study for me was that use of antiretrovirals during pregnancy was found to be safe for the exposed, uninfected infant with the one exception of efavirenz,” he added. “This should be reassuring to clinicians and mothers.”

The new research was led by Dr Rohan Hazra, chief of the maternal and paediatric infectious disease branch at the US National Institute of Child Health and Human Development.

Hazra’s team tracked data from more than 3 000 children born to US women who took HIV drugs during pregnancy. The children’s head circumferences were measured from age six months through five to seven years of age.

Lower development scores

The children’s head growth was assessed using two classification systems: one developed by the US Centers for Disease Control and Prevention for children under three years of age, and Nellhaus charts, which are used for children older than three years.

The study couldn’t prove cause and effect. But based on Nellhaus charts, children whose mothers took the HIV drug efavirenz were more than twice as likely to have microcephaly than those whose mothers took other HIV drugs.

Based on the combined Nellhaus-CDC standards, children exposed to efavirenz in the womb were around 2.5 times more likely to have microcephaly than those exposed to other HIV drugs in the womb.

Children with microcephaly based on Nellhaus charts also scored lower on standardised tests of development at ages one and five years.

Of the 141 children exposed to efavirenz in the womb, 14 (9.9%) had microcephaly, compared to 142 of 2 842 who were not exposed to efavirenz (5%), according to the US National Institutes of Health-funded study published online recently in The Lancet HIV.

“Our findings underlie the importance of having alternatives to combination therapy with efavirenz for pregnant women with HIV,” Hazra said in an NIH news release.

Image credit: iStock

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Health24.com | Tighter alcohol laws might help curb cancer

Policies that reduce drinking may lower rates of alcohol-related cancers, researchers say.

“When thinking about cancer risk and cancer prevention, the focus tends to be on individual-level risk factors rather than environmental determinants of cancer, like public policies that affect the consumption of alcohol or tobacco,” said study co-author Dr Timothy Naimi.

Further investigation merited

Naimi is a physician and researcher at Boston Medical Center and Boston University School of Public Health.

“Implementing effective policies to reduce alcohol consumption is a promising means of cancer prevention that merits further investigation,” Naimi added in a medical centre news release.

Alcohol use is linked to at least seven types of cancer. Research suggests that about 20 000 US cancer deaths a year are due to alcohol, the authors said in background notes.

For the new study, the researchers analysed data on cancer deaths per state from 2006 to 2010. They gave each state an alcohol policy score based on 29 regulations, such as alcohol taxes and restrictions on the number of locations allowed to sell booze.

Potential impact of policies

Those policy scores were then related to rates of alcohol-attributable cancers, such as those of the oesophagus, mouth and throat, liver, prostate (among men) and breast (among women).

For all cancers combined, more restrictive alcohol policies were associated with a reduced risk of cancer death. A 10% increase in the strength of alcohol policies was associated with an 8.5% decrease in cancer deaths, the findings showed.

The results were similar among men and women. They highlight the potential impact that public health policies can have on preventing cancers at the population level, according to the study authors. The findings were published online recently in the journal Chemico-Biological Interactions.

Image credit: iStock

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Drug that prevents half of breast cancers carries on working

Anastrozole is available already, but doctors say substantially more women should be taking it.

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Health24.com | How South Africa can build a child-centred health care system

It is more than 20 years since the South African constitution first guaranteed children’s “right to basic health care services”. This is part of a broader commitment to ensure children’s rights to optimal survival, health and development. The question is how close South Africa is to realising these rights in practice.

We address this issue in a chapter of the South African Child Gauge 2019 report.

Unlike adults’ right to health, children’s right to basic health care services is not subject to progressive realisation. Children should therefore be prioritised within the health care system. Yet the state has still not defined an essential package of health care services for children. This makes it difficult to determine what they are entitled to and what the state should be held accountable for.

Without a defined package, there’s a danger that the drive for efficiencies and cost saving may result in a limited basket of care that doesn’t address the complex needs of children. This is particularly true for those with chronic (long term) health conditions.

This essential package of care needs to be supported by a set of norms and standards. These need to specify the infrastructure, equipment, medicines and staff needed to meet the unique needs of children and adolescents. A clear package will also make explicit how health care establishments need to be equipped. These would include neonatal and paediatric wards as well as emergency medical services and primary health care services, where children currently have to compete for attention with sick and injured adults.

In other facets of the health system, too, budgets, building of infrastructure and medicine supplies need to consider children’s unique needs.

A child rights approach to health requires health professionals to treat children and their caregivers with respect and communicate effectively. Health care providers also need to build children’s and adolescents’ capacity to take responsibility for their own health and include them in decision making.

These fundamental shifts in the balance of power between adult and child, doctor and patient have been found to relieve pain and suffering. They also improve diagnosis, compliance with treatment, patient satisfaction and health outcomes.

Training health workers

The United Nations Committee on the Rights of Child has called for children’s rights to be integrated in the curriculum and performance criteria of all professionals working with children. These include health and allied professionals, teachers and social workers. The aim is to ensure that they are better attuned to children’s needs and rights.

For example, the LinCARE programme, where a team of health workers provides mother and child health care in Limpopo province, aims to reduce neonatal mortality. It does this by improving the quality of care during pregnancy and labour. The programme is aimed at ensuring that all women have a positive pregnancy and birth experience. It includes antenatal classes and ensures that women have practical and emotional support from a birth companion and kind, respectful and technically competent clinical staff.

As part of current preparation for a national health insurance system, which is aimed at extending universal health care to all South Africans, bolstering the primary health care system offers three opportunities to strengthen the child health workforce and improve the quality of care:

  • Community health workers play a central role in bringing health care services close to home, particularly for children living in poor or remote households. It’s therefore encouraging to see the national department of health’s commitment to employing them and paying them the minimum wage. This should improve supervision and support and ensure greater continuity of care between community-based services and health care facilities.

  • School health teams are another essential ingredient of the child system, helping to screen older children and address barriers to learning. Yet coverage reaches only one third of pupils in their first year of schooling and 20% of grade 8 learners. Its effectiveness is compromised by the shortage of health and other social service professionals, such as social workers, oral hygienists and dentists, psychologists, physiotherapists, speech and language therapists and occupational therapists.

  • Finally, district clinical specialist teams provide essential leadership for child and adolescent health at district level. For example, neonatal mortality has dropped by 30% in districts where there are paediatricians and paediatric nurses, yet less than half of specialist teams have a full paediatric team.

What needs to be done

The progress for child health has been uneven in South Africa with significant variation between provinces and districts. For example, immunisation varied from 90% in Mpumalanga to 69% in the Eastern Cape – signalling persistent inequities in access and coverage of care.

Given these challenges, greater investment is needed to strengthen systems and build a workforce for child and adolescent health. National health insurance provides an important opportunity to ensure universal health coverage and financial risk protection for the poor, as well as to improve the quality of care.

This requires leadership for child health at every level of the health care system – from individual encounters with children and their families, to ensuring that child health is adequately represented on key decision-making structures that will decide how resources are allocated.

Very importantly, it requires that the health sector works with and alongside other sectors. Interventions such as sufficient good quality food, good quality education, safe water and sanitation, good housing, safe roads and safe communities can significantly promote the health and well-being of children.

The South African Child Gauge 2019 report is published by the Children’s Institute at the University of Cape Town. The theme of the 2019 issue – “Child and adolescent health: leave no one behind” – is a call to prioritise child and adolescent health and put children at the heart of the health care system.

Lori Lake, a co-editor of the Child Gauge report, also contributed to this article.The Conversation

Maylene Shung-King, Professor, Health Policy, University of Cape Town

This article is republished from The Conversationunder a Creative Commons license. Read the original article.

Image credit: Duncan Alfreds, News24

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‘My boss lets us book hangover days’

One firm lets employees work from the comfort of their own sofa, even after they’ve been out drinking.

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