HIV babies at risk from standard TB vaccination

HIV-positive babies who receive the global standard tuberculosis (TB) vaccine are at high risk of contracting this infectious disease, says a new study in Bulletin, a journal published by the World Health Organisation (WHO).

HIV-positive babies who received the Bacillus Calmette- Guérin (BCG) vaccine were three times more likely to contract TB from the vaccine than previously thought. Earlier studies documented HIV-positive infants running a risk of contracting TB twice that of their HIV-negative peers as a result of the live cultures in the vaccine, which is fatal to more than 70% of all infants infected.

The new findings from research conducted in South Africa could change the vaccine regimens in countries with high rates of HIV and TB, according to an IRIN/PlusNews report.

Human Connectome Project to map brain

The US National Institutes of Health Blueprint for Neuroscience Research is launching a US$30 million project that will use cuttingedge brain imaging technologies to map the circuitry of the healthy adult human brain. By systematically collecting brain imaging data from hundreds of subjects, the Human Connectome Project (HCP) will yield insight into how brain connections underlie brain function, and will open up new lines of inquiry for human neuroscience.

Investigators have been invited to submit detailed proposals to carry out the HCP, which will be funded at up to $6 million per year for five years. The HCP is the first of three Blueprint Grand Challenges, projects that address major questions and issues in neuroscience research.

The Blueprint Grand Challenges are intended to promote major leaps in the understanding of brain function, and in approaches for treating brain disorders. The three Blueprint Grand Challenges to be launched in 2009 and 2010 address:

● The connectivity of the adult, human brain

● Targeted drug development for neurological diseases

● The neural basis of chronic pain disorders

“The HCP is truly a grand and critical challenge: to map the wiring diagram of the entire, living human brain. Mapping the circuits and linking these circuits to the full spectrum of brain function in health and disease is an old challenge but one that can finally be addressed rigorously by combining powerful, emerging technologies,” says Thomas Insel, MD, director of the National Institute of Mental Health, which is part of the NIH Blueprint.

In the HCP, researchers will optimise and combine state-ofthe- art brain imaging technologies to probe axonal pathways and other brain connections. Three imaging techniques are suggested, but are not required, for carrying out the HCP:

● High angular resolution diffusion imaging with magnetic resonance (HARDI), which detects the diffusion of water along fibrous tissue, and can be used to visualise axon bundles.

● Resting state fMRI (RfMRI), which detects fluctuations in brain activity while a person is at rest, and can be used to look for coordinated networks within the brain.

● Electrophysiology and magnetoencephalography (MEG) combined with fMRI (E/M fMRI), which adds information about the brain’s electrical activity to the fMRI signal. In this procedure, the person performs a task so that the brain regions associated with that task become active.

In addition to brain imaging, the HCP will involve collection of DNA samples, demographic information and behavioural data from the subjects. Together, these data could hint at how brain connectivity is influenced by genetics and the environment, and in turn, how individual differences in brain connectivity relate to individual differences in behaviour. Primarily, however, the data will serve as a baseline for future studies. This data will be freely available to the research community.

US NIH, Wikimedia collaborate for better info

The US National Institutes of Health (NIH) and the Wikimedia Foundation, the non-profit organisation that operates the Wikipedia online encyclopaedia, are working together to make health and science information more accessible and reliable. This collaboration is the first of its kind for both organisations.

To satisfy the public's growing need for reliable health information, NIH and the Wikimedia Foundation want to increase the availability of accurate medical and health information available to the public. At the same time, they hope to establish strategies to interlace the distinct cultures of Wikipedia and the research community.

“NIH works to ensure that the information it provides on science and health is of the highest quality and reaches the widest audience,” said John Burklow, NIH associate director for communications and public liaison.

In July the Wikimedia Foundation held their first official Wikipedia Academy in the United States, which was attended by a broad range of experts from the NIH with a view to showing them how to contribute to Wikipedia.

Stress during pregnancy affects child’s behaviour

An exhibit at the Royal Society Summer Science Exhibition in London in early July was set up by Imperial College London to raise awareness of the importance of reducing levels of stress and anxiety in expectant mothers. They say that reducing stress during pregnancy could help prevent thousands of children from developing emotional and behavioural problems.

The Imperial researchers’ work has shown that maternal stress and anxiety can alter the development of the baby’s brain. This in turn can result in a greater risk of emotional problems such as anxiety or depression, behavioural problems such as Attention Deficit Hyperactivity Disorder, and being considerably slower at learning. Some studies have even suggested that it may increase the likelihood of later violent or criminal behaviour. Their findings have suggested that the effects of stress during pregnancy can last many years, including into adolescence.

The researchers say that the stress hormone cortisol may be one way in which the foetus is affected by the mother’s anxiety during pregnancy. Usually the placenta protects the unborn baby from the mother’s cortisol, by producing an enzyme that breaks the hormone down. When the mother is very stressed, this enzyme works less well and lets her cortisol through the placenta. By studying the amount of cortisol in the amniotic fluid, the Imperial researchers’ study suggests that the higher the level of cortisol in the womb, the lower the toddler’s cognitive development or “baby IQ” at 18 months.

Suicidal behaviour associated with smoking cessation aids

The US Food and Drug Administration (FDA) notified healthcare professionals and patients early July that it has required the manufacturers of the smoking cessation aids varenicline (Chantix) and bupropion (Zyban and generics) to add new Boxed Warnings to the products in the United States and develop patient Medication Guides highlighting the risk of serious neuropsychiatric symptoms in patients using these products. These symptoms include changes in behaviour, hostility, agitation, depressed mood, suicidal thoughts and behaviour, and attempted suicide. The added warnings are based on the continued review of postmarketing adverse event reports for varenicline and bupropion received by the FDA. These reports included those with a temporal relationship between the use of varenicline or bupropion and suicidal events and the occurrence of suicidal ideation and suicidal behaviour in patients with no history of psychiatric disease.

US changes stance on global AIDS policy

Just a few weeks into his new appointment, United States Global AIDS Coordinator Dr Eric Goosby outlined in July some of the changes that President Barack Obama's administration will make to the country's global AIDS policy at the 5th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention in Cape Town, South Africa.

According to an IRIN report Goosby reassured delegates, many of whom are implementers of programmes funded by the US President's Emergency Plan for AIDS Relief (PEPFAR), that fighting AIDS would remain a central component of Obama’s foreign policy. However, there would be a renewed focus on other priorities such as maternal and child health, and tropical diseases.

Researchers estimate that 1.2 million deaths in Africa were averted between 2004 and 2007 as a direct result of interventions funded by PEPFAR, but the initiative has also attracted widespread criticism over the extent to which conservative ideology appeared to drive policy decisions.

“Our achievements will be more durable if we lay on top of health activities, development activities,” Goosby said, addressing concerns that PEPFAR programmes have been too focused on short-term goals to have an impact on the social and gender-related inequities that drive HIV/AIDS epidemics.He promised that PEPFAR would find ways to address gender inequities in particular, including by developing strategies to engage more with men.

During the Bush administration, interventions often neglected some of the populations most at risk of HIV infection. For instance, policies banned federal funding of needle exchange programmes for injecting drug users and placed restrictions on funding programmes aimed at sex workers.

Goosby also made it clear that scientific evidence rather than moral concerns would drive intensified efforts to reach highrisk groups – men who have sex with men, injecting drug users and sex workers – with HIV prevention and care.

US FDA reviewing possible cancer risk with insulin glargine

A statement released by the US Food and Drug Administration (FDA) says the organisation has notified healthcare professionals and patients that it is aware of four recently-published observational studies that looked at the use of Lantus (insulin glargine) and possible risk for cancer in patients with diabetes. Three of the four studies suggest an increased risk for cancer associated with use of Lantus. Based on the currently available data, the FDA recommends that patients should not stop taking their insulin therapy without consulting a physician.

The FDA is reviewing the many sources of safety data for Lantus, including these newly published observational studies, data from all completed controlled clinical trials, and information about ongoing controlled clinical trials, to better understand the risk, if any, for cancer associated with use of Lantus. Discussions are also ongoing between FDA and the manufacturer of Lantus as to whether any additional studies evaluating the safety and efficacy of this drug will need to be performed. The FDA said it would communicate the results of its ongoing review in due course.

New York’s World Product Centre to facilitate collaboration

The ambitious World Product Centre – a US$1 billion, 60- floor skyscraper in New York City geared to support healthcare innovation and collaboration – is set to get off the ground early next year and should be open by late 2013. The aim of the centre is to gather leading medical technology companies under one roof and it appears to be getting off to a good start with several leading healthcare companies signing up, including the likes of Cardinal Health, one of the world's largest healthcare suppliers; Zimmer, a global orthopaedic manufacturer; and Encompass Group, a manufacturer and distributor of healthcare textiles, uniforms and architectural products addressing patient safety.

Also signing on are seven of the portfolio companies under the healthcare-focused private equity partnership Roundtable Healthcare Partners: ACI Medical, a biomedical engineering firm engaged in manufacturing and sales of therapeutic products and technologies for individuals with varying degrees of life-impairing vascular conditions; Bioniche Pharma, a leading developer and manufacturer of injectable pharmaceuticals; Aspen Surgical, a worldwide leader of specialty medical products; CorePharma, a manufacturer and marketer of generic pharmaceuticals; Avalign Technologies, a premier, full-service supplier of implants, instruments, and delivery systems; Excelsior Medical, a medical device company offering products that fulfil the needs of the healthcare practitioner; and Vesta, a contract manufacturer with innovative solutions in medical grade silicone moulding and extrusion.

Mark Rosenbaum, Chief Customer Officer for Cardinal Health, explained: “The development of World Product Centre provides a transparent, neutral location for healthcare providers to evaluate products and services from a variety of manufacturers and distributors.” The World Product Centre will feature a year round trade show of medical technology, office space, and conferencing facilities.


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