News in Brief

Carestream ships 15,000th tabletop CR

Carestream Health announced recently it has shipped its 15,000th tabletop CR system, driven by strong worldwide demand for its affordable, reliable computed radiography systems across Asia, China, Europe, Japan, Latin America, Middle East and the United States.

MRI shown to be safe for patients with pacemakers

Magnetic Resonance Imaging (MRI) has traditionally been off limits to people who have an implanted pacemaker. However, cardiologists at Johns Hopkins report that a protocol they developed has proved effective in enabling patients with implanted cardiac devices to safely undergo an MRI scan. Their study is published in the 4 October 2011issue of Annals of Internal Medicine. “The guidelines we have published can be used to make MRI more available to people who could benefit from early detection of cancer and other diseases and for guiding surgeons during procedures,” says lead author Saman Nazarian, a Johns Hopkins cardiac electrophysiologist.

HIV combination strategy trial

A team of researchers led by Professor Richard Hayes at the London School of Hygiene and Tropical Medicine has been awarded $37 million to test an innovative combination of strategies to prevent HIV in African countries. The project, called Population ART (PopART), will test the impact of a combination prevention strategy that combines communitywide house-to-house voluntary testing for HIV, offer of medical circumcision to men who test HIV-negative, and offer of immediate initiation of antiretroviral therapy (ART) for all those testing HIV-positive.

Researchers find cause of MRI vertigo

A team of researchers says it has discovered why so many people undergoing magnetic resonance imaging (MRI), especially in newer highstrength machines, get vertigo, or the dizzy sensation of free-falling, while inside or when coming out of the tunnel-like machine. In the study published in Current Biology online on 22 September 2011, scientists suggest that MRI’s strong magnet pushes on fluid that circulates in the inner ear’s balance centre, leading to a feeling of unexpected or unsteady movement. The finding could also call into question results of so-called functional MRI studies designed to detect what the brain and mind are doing under various circumstances.

Prize for neuro-degenerative research

This year’s Fernström Foundation Nordic Prize, with prize money of SEK 1 million (about US$150,000), goes to Professor Anders Björklund from Lund University, Sweden. He is a neurology researcher focusing on neurodegenerative diseases. Professor Björklund’s research group is trying to develop customised stem cells to treat Parkinson’s disease. This year’s prize recognises Björklund’s “development of innovative forms of treatment for Parkinson’s disease”.

Stem cells cure sickle cell disease

Using a patient’s own stem cells, researchers at Johns Hopkins have corrected the genetic alteration that causes sickle cell disease (SCD), a painful, disabling inherited blood disorder. The corrected stem cells were coaxed into immature red blood cells in a test tube that then turned on a normal version of the gene. The research team cautions that the work, done only in the laboratory, is years away from clinical use in patients, but should provide tools for developing gene therapies for SCD and a variety of other blood disorders. The research is published online 31 August 2011 in Blood.

China vaccinates against polio after outbreak

China vaccinated 4.5 million children and young adults over five weeks in late September early October in the western region of Xinjiang in a fight against polio after the disease paralyzed 17 people and killed one of them, according to the WHO.

Cholera outbreak ‘one of worst ever’

The United Nations Children’s Fund has called for an urgent increase in the efforts to combat “one of the worst ever” cholera outbreaks affecting large numbers of people across West and Central Africa. This year the region has had more than 85,000 reported cholera cases, resulting in 2,466 deaths, which make it one of the biggest epidemics in the region’s history.

Climate change ‘a global health catastrophe’

Environmental health experts, scientists and government officials attending a conference in London in October, sponsored by the British Medical Journal, issued a statement warning that climate change could not only bring a global health catastrophe but could threaten global stability and security as well. Ahead of the climate change conference in Durban, South Africa, in December, the group called upon governments around the world to prioritise efforts to address the causes and impacts of climate change.

FDA approves Ferriprox for iron overload

The US FDA has approved Ferriprox (deferiprone) to treat patients with iron overload due to blood transfusions in patients with thalassemia, a genetic blood disorder that causes anaemia, who had an inadequate response to prior chelation therapy. Ferriprox is marketed by ApoPharma of Toronto. The company has committed to further study of the use of Ferriprox in patients with sickle cell disease who have transfusional iron overload.

LeGoo approved

The US Food and Drug Administration has approved LeGoo, manufactured by PluroMed of Woburn, Massachusetts, US. LeGoo is a gel that allows surgeons to temporarily stop blood flow during surgery so that they can join blood vessels without clamps or elastic loops. It has been shown to minimise blood flow into the surgical area without damaging blood vessels. Standard tools, such as elastic loops and clamps, do not always allow for a bloodless surgical area and may damage vessels. 

Global call to action to fight antibiotic resistance

Over 70 international experts in medicine, infectious diseases, microbiology and epidemiology, from every continent, gathered recently at the Fondation Mérieux’s Conference Center for the third edition of the World HAI Forum on healthcare-associated infections, a bioMérieux initiative. Forum participants called upon national and international health authorities and policy makers, the medical and veterinary communities, industry, and the general public to take action to avoid an impending public health catastrophe caused by the emergence and spread of bacteria that are resistant to all antibiotics.

While research to discover novel antibiotics has slowed to a virtual standstill, bacterial resistance has increased due to the massive use and misuse of antibiotics, not only for human health, but also for animals. The treatment of certain common infections is becoming difficult and the success of immunosuppressive therapies and surgical interventions (organ transplants, cardiac surgery), which are associated with a high risk of bacterial infection, could be compromised.

To the Forum experts, the emergence of pan-resistant NDM-1 bacteria and an epidemic of multidrug-resistant E. coli infections currently in Europe, should be taken as a major public health warning, indicating that a new era of antimicrobial resistance has begun.

In a continuation of calls to action and proposals made by major national and international organisations (WHO, ECDC, IDSA, CDC, etc.), the Forum’s participants identified priority action areas to fight bacterial resistance and recommended 12 very concrete actions to be implemented, in the short to mid-term, to effectively address this serious problem.

- Priority actions
- For animals, stop the administration of antibiotics used in human medicine and limit antibiotics to therapeutic use only. It is imperative to reserve the most important classes of antibiotics for humans.
- Banish, in all countries, the use of antibiotics as growth promoters in animal feed.
- Regulate the sale of antibiotics for use in human medicine and prohibit overthe- counter sales worldwide.
- Have international organisations (WHO, European Union) develop a charter on good antibiotic stewardship and have all the ministries of health worldwide sign it and commit to respecting it.

US scientists to develop new technology to predict drug safety

US President Obama announced that the National Institutes of Health will collaborate with the Defense Advanced Research Projects Agency (DARPA), and the US Food and Drug Administration to develop a chip to screen for safe and effective drugs far more swiftly and efficiently than current methods, and before they are tested in humans. The chip will be loaded with specific cell types that reflect human biology. It will be designed to allow multiple different readouts that can indicate whether a particular compound is likely to be safe or toxic for humans. DARPA and NIH will run separate and independent programmes, but they will work closely to ensure maximum benefit and efficiencies. For example, DARPA and NIH will facilitate collaborations between researchers and FDA to advance the goals of both programmes. This fall, the two agencies, in coordination with FDA, will solicit proposals from industry, government labs, academic institutions, and other research organisations on how best to develop the chip, bringing together the latest advances in engineering, biology, and toxicology to bear on this complex problem.

“Drug toxicity is one of the most common reasons why promising compounds fail,” Francis S. Collins, MD, PhD, NIH director said. “We need to know which ones are safe and effective much earlier on in the process. This is an unprecedented opportunity to speed development of effective therapies, while saving time and money.”

Over the next five years, the NIH plans to commit up to US$70 million and DARPA will commit a comparable amount to this effort. This groundbreaking effort is an example of the types of innovative projects that would be led by the proposed National Center for Advancing Translational Sciences (NCATS). NCATS would help identify barriers to progress and provide sciencebased solutions to reduce costs and the time required to develop new drugs and diagnostics. FDA will help determine how this new technology can be utilised to assess drug safety, prior to approval for firstin- human studies.

GE Healthcare to invest US$1bn in cancer diagnostics

GE Healthcare plans to dedicate US$1 billion of its total R&D budget over the next five years to expand its advanced cancer diagnostic and molecular imaging capabilities, as well as its world-class technologies for the manufacture of biopharmaceuticals and for cancer research.

The recently announced investment commitment reflects the needs of the healthcare sector across the world, and in the Middle East, which today faces the twin challenges of rising healthcare bills and the growing incidence of lifestyle diseases.

According to recent reports, the prevalence of diabetes, cardiovascular ailments and certain forms of cancer are increasing in the Middle East and North Africa region, while healthcare expenditure as a percent of the GDP is relatively low, underlining the need for greater private sector collaboration in driving healthcare research.

The US$1 billion global investment crosses all lines of GE Healthcare’s global business and is an example of the company’s commitment to fighting cancer. The investment will enable the company to bring innovative tools to market, unleashing technologies that can improve the accuracy of diagnosis to potentially enable more effective treatment decisions and empower doctors and patients with better information.

According to World Health Organisation data, cancer rates could increase globally by 50%, leading to 15 million new cases in 2020. From a clinical standpoint, the rapid increase in targeted and patient-specific cancer therapies is driving demand for molecular diagnostics.

Health-seeking behaviour on the Web

Eight out of every ten physicians report experience of patients presenting printed internet-sourced health information at visits, which suggests a new dynamic in the traditional doctor–patient relationship. This is one of the findings of the literature review on health informationseeking behaviour on the web that European Centre for Disease Prevention and Control (ECDC) published 4 October 2011.

The purpose of the review is to provide an overview of online health informationseeking behaviour by adults from the perspective of both the health consumer and the health professional. Research shows that, although they have difficulty identifying and filtering the most useful, accurate and credible sources, the health professionals use of the internet to obtain health and medical information has increased.

As for the online health consumer, they tend to be more educated, earn more, and have high-speed internet access at home and at work. The literature review also shows that women are more likely than men to search for health information. The literature review, one in a series of ‘Insights into health communication’ on the prevention and control of communicable disease in the European context, focuses on research published from 2006 to 2010 in English language.

“A literature review on health information-seeking behaviour on the web: a health consumer and health professional perspective”

Existing interventions can prevent 66% of newborn deaths

Fewer newborns are dying worldwide, but progress is too slow and Africa particularly is being left further behind. These are the findings of a new study published in the medical journal PLoS Medicine. The study covering 20 years and all 193 WHO Member States was led by researchers from the World Health Organization (WHO), Save the Children and the London School of Hygiene and Tropical Medicine. The estimates are based on more data than ever and extensive consultations with countries. The study shows detailed trends over time and forecasts potential future progress.

Newborn deaths decreased from 4.6 million in 1990 to 3.3 million in 2009, but fell slightly faster since 2000. More investment into health care for women and children in the last decade when the United Nations Millennium Development Goals (MDGs) were set, contributed to more rapid progress for the survival of mothers (2.3% per year) and children under the age of five (2.1% per year) than for newborns (1.7% per year).

According to the new figures, newborn deaths, that is deaths in the first four weeks of life (neonatal period), today account for 41% of all child deaths before the age of five. That share grew from 37% in 1990, and is likely to increase further. The first week of life is the riskiest week for newborns, and yet many countries are only just beginning postnatal care programmes to reach mothers and babies at this critical time.

Three causes account for three quarters of neonatal deaths in the world: preterm delivery (29%), asphyxia (23%) and severe infections, such as sepsis and pneumonia (25%). Existing interventions can prevent two-thirds or more of these deaths if they reach those in need.

“Newborn survival is being left behind despite well-documented, cost-effective solutions to prevent these deaths,” says Dr Flavia Bustreo, WHO Assistant Director- General for Family, Women’s and Children’s Health. “With four years to achieve the Millennium Development Goals, more attention and action for newborns is critical.”

Almost 99% of newborn deaths occur in the developing world. The new study found that in part because of their large populations, more than half of these deaths now happen in just five large countries – India, Nigeria, Pakistan, China and Democratic Republic of the Congo. India alone has more than 900,000 newborn deaths per year, nearly 28% of the global total. Nigeria, the world’s seventh most populous country, now ranks second in newborn deaths up from fifth in 1990. This is due to an increase in the total number of births while the risk of newborn death has decreased only slightly. In contrast, because the number of births went down and the risk of newborn death was cut in half (23 to 11 per 1000), China moved from second place to fourth place.

Neonatal Mortality Levels for 193 Countries in 2009 with Trends since 1990: A Systematic Analysis of Progress, Projections, and Priorities

Substance abuse among youth in Europe falls

The Youth in Europe (YIE) drug prevention programme has released research tracking the incidence of smoking (daily), drinking and cannabis experimentation amongst 15 to 16-year-old students in Iceland from 1998 to 2011. And the results are astonishing.

The number of young people who got drunk within the last 30 days has dropped from 42% in 1998 to just 9% in 2011. The level of youngsters smoking on a daily basis has decreased from 23% to 5%, and those experimenting with cannabis from 17% to 3%.

YIE is considered by many to be the biggest health promotion project targeting youth substance abuse across Europe. This evidence-based, international programme was initiated by European Cities Against Drugs (ECAD) and is carried out in cooperation with major European cities. Taking a broadly holistic approach, its aim is to decrease the likelihood of substance use among young people. The city of Reykjavik, Iceland, serves as the chair and provides management for this programme, while research is conducted by the Icelandic Centre for Social Research and Analysis (ICSRA).

WHO mental health

One in four people will require mental health care at some point in their lives but in many countries only 2% of all health sector resources are invested in mental health services.

Average global spending on mental health is still less than US$3 per capita per year. In low income countries, expenditure can be as little as $0.25 per person per year, according to the WHO’s Mental Health Atlas 2011, released on World Mental Health Day.

The report also finds that the bulk of those resources are often spent on services that serve relatively few people.

“Governments tend to spend most of their scarce mental health resources on long-term care at psychiatric hospitals,” says Dr Alaa Alwan, Assistant Director- General of Noncommunicable Diseases and Mental Health at WHO. “Today, nearly 70% of mental health spending goes to mental institutions. If countries spent more at the primary care level, they would be able to reach more people, and start to address problems early enough to reduce the need for expensive hospital care.”

The Atlas highlights other imbalances. Good mental health services focus equally on providing patients with a combination of medicines and psychosocial care. In lower income countries, however, shortages of resources and skills often result in patients only being treated with medicines. The lack of psychosocial care reduces the effectiveness of the treatment.

Meanwhile, many people have no access to mental health services at all. Across the low-and middle-income group of countries, more than three quarters of people needing mental health care do not even receive the most basic mental health services.

“Almost half of the world’s population lives in a country where, on average, there is one psychiatrist (or less) to serve 200,000 people, says Dr Shekhar Saxena, Director, Mental Health and Substance Abuse at WHO. “Many low-income countries have less than one mental health specialist per one million population.”

In 2008, WHO launched its mental health Gap Action Programme (mhGAP) to assist countries to scale up services for mental, neurological and substance use disorders. The programme provides knowledge and skills to primary health care providers such as general doctors, nurses and health care workers to identify and manage these disorders.

Since then, some countries have made significant progress in scaling up their services with assistance from WHO. For example:

- Ethiopia and Nigeria have begun training their primary health care personnel to identify and treat priority mental disorders. The Ministries of Health of both countries have committed to sustain the programme for lasting impact;

- China has scaled up its programme to provide care for epilepsy patients to 19 provinces, building on successful experience in a small number of pilots in provinces. More than 40 million people are now covered by this programme;

- Jordan is making progress with a programme for priority mental disorders. Panama has begun training its primary care providers on a systematic basis;

- Large, developing countries like Brazil, India and Thailand are also preparing to make rapid advancements in scaling up care through their national health programmes.

Polio reappears in Madagascar

While no cases of polio have been detected in Madagascar since 1997, the Ministry of Health announced in October that they had identified 6 new cases in the south of the country in the remote areas of Fort Dauphin and Tulear, raising fears of a new resurgence of the epidemic of polio.

The low immunisation rates combined with health problems and malnutrition may well contribute to a reoccurrence of this disease. A MoH report in 2010 showed that only 70% of Malagasy children were vaccinated against polio.


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