Government curbs random use of stem cells for therapeutic purposes

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For adults, stem cells can be used for therapeutic purposes in cases of leukemia and lymphomas, solid tumours such as germ cell and some non-cancerous diseases of the blood.
In order to curb the misuse of stem cell treatments, the Indian Council for Medical Research (ICMR) and the Department of Biotechnology (DBT) released updated national guidelines on Wednesday that restrict the use of stem cell therapy.

For adults, stem cells can be used for therapeutic purposes in different cases of leukemia (cancer of the blood) and lymphomas (cancer of the lymphatic system), solid tumours such as germ cell, and non-cancerous diseases of the blood such as severe aplastic anaemia, sickle cell disease, among others.

In children, the therapy is also permitted in different types of blood cancers, solid tumours of brain, bones, etc, and non-cancerous diseases such as thalassemia major, juvenile rheumatoid arthritis, and osteopetrosis, among others.

At the moment, certain medical practitioners offer stem cell therapy for conditions even outside their speciality and for conditions where there has been no proven cure through this treatment.

“The 2017 guidelines reiterate that any stem cell use in patients, other than that … for approved indications, is investigational at present… every use of stem cells in patients outside an approved clinical trial is unethical and shall be considered as malpractice,” says the report.

An expert, on condition of anonymity, said, “Even clinical trials in stem cell treatments should only be done by domain experts. However, these days you would find stem cell clinics almost everywhere. It is an expensive treatment modality and you can’t fool people.”

The guidelines elaborately mention categories where stem cell use “permissible, restrictive or prohibited”.

The use of stem cells has been strictly prohibited in human germ line gene therapy, wherein changes are made to the DNA that will be passed on to the next generation, and human cloning; use of gene modified human embryos; breeding of animals in which any type of human stem cells have been introduced at any stage of development, etc.

“India has a large unmet medical need, which requires facilitation of safe and regulated translational and clinical stem cell research,” says the report.

Dr Soumya Swaminathan, director general, ICMR, said, “These are the updated guidelines keeping in mind the advances that have happened in the field. It is a fast-paced area and needs constant upgradation.”

Source: http://www.hindustantimes.com/health/government-curbs-random-use-of-stem-cells-for-therapeutic-purposes/story-EWjiXbW5YqUxLLKG16IqJK.html

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Do you suffer from the flu every winter? A new shot may protect you for years

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Researchers are trying to develop a new influenza shot, which could mean just one jab will protect you for many flu seasons.
US researchers may be on their way to developing a new influenza shot, which could mean just one jab will protect you for many flu seasons to come. David Putnam and Matt DeLisa from the William L. Lewis Professor of Engineering in Cornell’s Robert Frederick Smith School of Chemical and Biomolecular Engineering have been researching strains of the influenza, or flu, virus, which change every year because some of the proteins in the virus mutate.

However, as some proteins stay the same, the pair have been able to take one of the Matrix-2 (M2) protein, and attempt to package it in a controlled-release “capsule” to make a new flu shot. Their hope is that the new shot will be a quick-acting, long-lasting, multi-strain vaccine against influenzaA, and would mean maybe just one jab would be sufficient for protection.

The influenza A virus can be described as a “moving target” as it changes from year to year and can morph into a pandemic strain — meaning it is infectious across a large region — which can put the general population at risk. The new bacterial outer membrane vesicle (OMV) capsule, which has been engineered from nonpathogenic E. coli and has an outer surface that mimics the cell from which it originated, has now been tested by the team on mice to assess its efficacy against the virus.

OMVs have already shown to have potential for protecting against other deadly pathogens. As the M2 protein is found in the influenza sequence in birds, pigs and humans, the group took two sequences from birds, one from pigs and one from humans, and brought them together into one multi-target antigen. “So even if, say, the human strain mutates,” Putnam said, “we know where it came from and it’s going to look like the other two. We kind of covered all the bases.”

The pair then gave the vaccine to mice infected with the influenza A virus. They found that those who were given the OMV vaccine developed high antibody counts just four weeks after vaccination, whereas mice given a typical multishot vaccine regimen developed antibodies after eight weeks. In addition, the results also showed the effects of the OMV vaccine were long-lasting, with the team observing that even after six months, all of the mice given the OMV vaccine survived a lethal influenza A infection. As six months is approximately 25% of the typical life expectancy for a mouse, Putnam believes it is likely that the OMV vaccine would be long-lasting for humans, too.

“Even if we have to give a booster shot every 10 years, like tetanus, that’s still very good,” he said. The findings can be found published online in the journal Vaccine.

Source: http://www.hindustantimes.com/health/do-you-suffer-from-the-flu-every-winter-a-new-shot-may-protect-you-for-years/story-OwyoDv1jQxoaWe5PF8jkkM.html

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Night time surgeries have more complications

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A new study published in Neurosurgery finds that patients who undergo a neurosurgical procedure with surgical start times between 9 pm and 7 am are at an increased risk of developing complications compared to patients with a surgical start time earlier in the day.

Neurosurgical procedures are necessary at all times of day. Previous studies have documented the relationship between surgical and medical management of diseases at night leading to worse outcome and it has particularly been exemplified in those undergoing: coronary angioplasty, orthopedic surgery, transplant surgery, colorectal surgery, and cardiac arrest patients. Other surgical specialties have examined the effect of surgical start time on morbidity and mortality; however, a similar study has not been performed for neurosurgical procedures.

Researchers here analyzed all patients undergoing neurological surgery between 2007 and 2014 in the University of Michigan Health System. This study included 15,807 patients. 785 complications were identified through the self-reported morbidity and mortality reports created by faculty and resident neurosurgeons.

The study showed that the odds of a complication were increased by more than 50% for procedures with start times between 9 pm and 7 am. When accounting for the length of the surgery, the odds of a complication were even greater for later time periods. The only statistically significant factor that predicted severity of the complication was if the operation was an emergency compared to an elective surgery.

The researchers believe that it is of the utmost importance to understand whether surgical start time might be related to neurosurgical procedural complications. Other surgical specialties have studied the negative relationship between late surgical start times and clinical outcome. The goal with this retrospective cohort study was to understand the relationship of surgical start time to the development of neurosurgical morbidity and mortality.

Research indicates that the time an activity begins is important; if a task is accomplished outside the “normal” timeframe for completing the task (i.e. after-hours or on the weekend) then the outcomes from that task are statistically worse.

Demographic comparisons across start time groups revealed that the average age of the patient population varied across the surgical day with higher ages earlier in the day, and lower ages later in the day. While other patient factors varied over the course of the day, the magnitude of variation was unlikely to be clinically significant.

As would be expected, as it got later in the day, the percentage of elective cases decreased while emergency cases predominated.

The analysis demonstrated that a patient’s odds of having a surgical complication increased significantly between 9 pm and 7 am even after accounting for whether the case was an emergency versus elective procedure or if the patient had co-morbid conditions. When accounting for the length of the surgery, the odds of a complication more than doubled. In other words, after-hour complications are not any more or less severe than non-after hour complications; however, they are much more common. The authors acknowledge that while the after-hour effect is a potential explanation for the increased odds of complications with later surgical start times, there could be other explanations. For example, it could be that patients treated after normal business hours are inherently sicker than patients treated during normal business hours in ways that the authors were unable to measure, leading to increased complications rates.

“We need to continue to study this relationship as we aim to minimize surgery related complications,” said lead author Aditya Pandey. “Could it mean that health systems need to invest more with respect to increasing the number of surgical teams and operating rooms to allow for greater proportion of surgeries to be performed during day hours and that urgent cases should be stabilized and performed during day hours? These are important questions that must be raised as we continue to solidify the relationship between surgical start time and surgical complications.”

Source: https://www.sciencedaily.com/releases/2017/10/171013123202.htm

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DNA study provides insight into how to live longer – BBC

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The researchers say a person loses two months for every kilogram overweight they are – and seven years for smoking a packet of cigarettes a day.
Unusually, the Edinburgh university team found their answers by analysing differences in people’s genetic code or DNA.
Ultimately they think it will reveal new ways of helping us to live longer.
The group used the genetic code of more than 600,000 people who are taking part in a natural, yet massive, experiment.
Clearer picture
If someone smokes, drinks, dropped out of school and is overweight, it can be difficult to identify the impact of one specific unhealthy behaviour.
Instead, the researchers turned to the natural experiment.
Some people carry mutations in their DNA that increase appetite or make them more likely to put on weight, so researchers were able to compare those programmed to eat more with those who were not – irrespective of their wider lifestyles.
Dr Peter Joshi, from the university’s Usher Institute, said: “It doesn’t mess up the analysis. You can look directly at the effect of weight, in isolation, on lifespan.”
Similar sets of mutations have been linked to how long people spend in education and the enjoyment they get from smoking or drinking.
The research team also found specific mutations in human DNA that alter lifespan, reported in the journal Nature Communications.
Mutations in a gene (a set of instructions in DNA) that is involved in running the immune system could add seven months of life on average
People with a mutation that increased levels of bad cholesterol knocked eight months off life expectancy
A rare mutation in a gene – APOE – linked to dementia reduced lifespans by 11 months
And one that made smoking more appealing cut lives by five months
Dr Joshi says these genetic variants are the “tip of the iceberg”. He says around 20% of the variation in lifespans may be inherited, but only 1% of such mutations have yet been found.
However, he said that while genetics does influence lifespan, “you’ve got even more influence” through the choices you make.
Dr Joshi told the BBC: “We hope to discover novel genes affecting lifespan to give us new information about ageing and construct therapeutic interventions for ageing.”
There are also some disease mutations that clearly affect life expectancy, and to devastating effect, such as the Huntington’s gene. People with Huntington’s often die in their 20s.
However, in order to follow people until the end of their lives, many of the people studied were born before 1940.
Prof David Melzer, from the University of Exeter Medical School, said: “An extra year of education then may have been much more important than it is now.”

Source: http://www.bbc.com/news/health-41588613

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Protein injection could prevent hair loss during chemotherapy

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Mice injected with a hair-promoting protein did not lose their hair during chemotherapy. The finding raises the hope that people undergoing cancer treatment can one day avoid this distressing side effect.

Hair loss is one of the most feared side effects of chemotherapy. One study of women with breast cancer found that around 8 per cent had considered refusing treatment to save their locks.

There are few options for people receiving treatment. Scalp-cooling caps freeze and constrict blood vessels to stop chemo drugs from flowing into hair follicles. But they are expensive, work for only 50 per cent of people, extend treatment by two hours and cause discomfort and headaches.

Other people have experimented with using the hair loss treatment minoxidil during chemo, but a randomised controlled trial found no benefit.

Part of the problem is our limited understanding of how chemotherapy damages hair follicles, says Sung-Jan Lin at National Taiwan University.

To address this, his team looked at the role of a protein called p53. This protein is activated during chemo and helps to suppress tumour growth, but may also suppress hair growth, since hair cells rapidly divide like tumour cells. A previous study found that mice missing the p53 protein did not shed their fur during chemo.

Hair-promoting protein
Studying p53, Lin and his colleagues have found that it blocks the activity of a hair-promoting protein called WNT3a. This gave them an idea: if you inject WNT3a directly into the scalp when administering chemo, will it stop hair loss?

To test this, they dosed mice with a common chemotherapy agent. Straight afterwards, they injected WNT3a-soaked beads under the surface of their skin. The microscopic beads – which were coloured blue – helped to keep the protein in a small area so the team could study its effects.

Sure enough, areas injected with the WNT3a-soaked beads were still coated with thick fur five days after chemo. In contrast, areas injected with untreated beads went bald.

When the researchers examined patches of skin under the microscope, they found the protein treatment doubled the number of stem cells in the base of the hair follicles within the first day of injection, allowing more hairs to sprout.
The team is now working on adapting the treatment for use in people. It would not be practical or safe to inject the hair-promoting protein into the scalp in bead form, says Lin. “We might need to inject it into the scalp using arrays of fine needles so that many of the hair follicles can be covered,” he says. His team is also testing compounds they have designed for activating WNT3a that could be spread over the scalp in cream or gel form.

Richard de Boer, a medical oncologist at Epworth Centre in Melbourne, Australia, says the treatment could be a big help. While scalp cooling has led to many success stories, it doesn’t work well for some types of chemotherapy, he says. “New hair-saving options that work with all chemotherapy regimens would be very welcome.”

Watch video

Journal reference: Cancer Research, DOI: 10.1158/0008-5472.CAN-17-0667

Source: https://www.newscientist.com/article/2149608-protein-injection-could-prevent-hair-loss-during-chemotherapy/

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Two in one? New pill may curb type 2 diabetes and aid weight loss

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The study was conducted by a team from Leicester Diabetes Centre. Patients who were taking Metformin were given the pill.

Diabetes is considered to be a silent killer by medical professionals across the world. Even a single symptom reflecting the onset of the disease is a cause for concern.

It is a disease that could be hereditary and can also develop due to an unhealthy lifestyle.

Semaglutide is reportedly the first pill to help incite weight loss, according to a report by the Daily Mail. 71% of the 632 patients in the study were able to loose weight test results revealed.

The study was conducted by a team from Leicester Diabetes Centre. Patients who were taking Metformin were given the pill.

There are many medically prescribed ways and means to ensure prevention from developing the potentially lethal disease and those who are at immediate risk, are often advised diet control.

Researchers are hoping the new pill can control the common condition as some of the treatment currently available provokes weight gain and worsens type 2 diabetes. The pills also stopped patients from needing insulin.

The pill could offer a relief for those who struggle with injecting themselves. “For some patients injectable therapies are a problem, so having something available orally makes it more accessible to some patients,” lead author Professor Melanie Davies told the Daily Mail.

Type 2 diabetes is deadly as it can cause heart failure, blindness and leg amputations. “Type 2 diabetes is a serious condition with potentially devastating complications which is posing a major challenge to health services across the world because of the increasing numbers of people developing it,” Professor Davies told the Daily Mail.

Many experts are enthusiastic about the findings. “These latest results are hugely encouraging and will be welcomed across the diabetes community,” Oliver Jelley, editor of The Diabetes Times told the Daily Mail.

The findings were published in the JAMA.

Source: http://zeenews.india.com/health/two-in-one-new-pill-may-curb-type-2-diabetes-and-aid-weight-loss-2050837

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Finally a cure ? New vaccine raises hope of reducing pneumonia deaths

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An experimental vaccine that targets dozens of strains of the bacterium that causes pneumonia has the potential to significantly bring down the number of deaths due to the disease, a new study says.

The vaccine provoked an immune response to 72 forms of Streptococcus pneumoniae in laboratory tests on animals, according to the study published in the journal, ‘Science Advances’.

“We’ve made tremendous progress fighting the spread of pneumonia, especially among children. But if we’re ever going to rid ourselves of the disease, we need to create smarter and more cost-effective vaccines,” said the study’s co-lead author Blaine Pfeifer, Associate Professor at University at Buffalo in New York.

In 2004, pneumonia killed more than two million children worldwide, according to the World Health Organization (WHO). By 2015, the number was less than one million.

Better access to antibiotics and improved nutrition account for part of the decline. But scientists say it’s mostly due to vaccines introduced in the early 2000s that target up to 23 of the most deadly forms of the bacterium that causes pneumonia — Streptococcus pneumoniae.

As the new vaccine under development targets additional strains of S. pneumoniae — including the 23 mentioned above – it could, the researchers beleive, deal another blow to the disease.

Source: http://www.newindianexpress.com/lifestyle/health/2017/oct/21/new-vaccine-raises-hope-of-reducing-pneumonia-deaths-study-1679138.html

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MRI Predicts Potential Recovery from Cardiac Arrest Related Brain Damage

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MRI, which measures functional connections in the brain may be used to predict long-term recovery in patients who suffer neurological disability after cardiac arrest, says study. The Findings are published in the journal Radiology.

Cardiac arrest, or abrupt loss of heart function, is a common and often deadly occurrence that affects hundreds of thousands of people every year in the United States alone, according to the American Heart Association. Many patients who survive end up with severe neurological disabilities, as the temporary loss of oxygenated blood flow to the brain can result in widespread neuronal cell death.

The researchers assessed the brain’s functional connectivity in 46 patients who were in a coma following cardiac arrest. The imaging, performed within two weeks of cardiac arrest, included studies of brain structure and function. Functional imaging focused on four well-characterized networks in the brain, including the default mode network, which is active when a person is not engaged in a specific task, and the salience network, a collection of brain regions that select which stimuli are deserving of our attention.

One year after the patients’ cardiac arrests, the researchers assessed the patients with the Cerebral Performance Category Scale, a commonly used measure of neurological function following cardiac arrest. Eleven patients had favorable outcomes. Functional connectivity was stronger in those who achieved higher levels of independence at one year compared with those who were heavily dependent. The changes in functional connectivity between networks predicted outcomes with greater accuracy than any of the MRI structural measures tested.

“This is game-changing information about what happens in the brains of people who suffer cardiac arrest,” Dr. Stevens said. “We realize that network architectures can be selectively disrupted in this setting.”

A key predictor of outcomes was the interaction between the brain’s default mode and salience networks. These two networks are normally anti-correlated, meaning that as the default mode network becomes more active, activity is reduced in the salience network, and vice versa. When researchers compared the brain imaging results of patients who had favorable outcomes with those who did not, they noticed a stark difference.

“Anti-correlation was preserved in patients who recovered and abolished in those who did not,” Dr. Stevens said. “Relative preservation of this anti-correlation was the most robust signal of a favorable outcome.”

The results indicate that connectivity measures could be early markers of long-term recovery potential in patients with cardiac arrest-related brain damage, the researchers said.

While researchers don’t expect connectome analysis with MRI to be the single “magic bullet” solution to predicting outcomes, it could increase the confidence that clinicians have in communicating with patients’ families in the wake of cardiac arrest. Additionally, fMRI could aid in the development of therapeutic interventions for neurologically disabled patients.

“Connectome studies have the potential to change not only outcome prediction, but to guide treatment as well,” Dr. Stevens said.

Source: http://www.medindia.net/news/mri-predicts-potential-recovery-from-cardiac-arrest-related-brain-damage-173880-1.htm

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Good News! Blood test can effectively rule out breast cancer, regardless of breast density

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With over a 99 percent negative predictive value, a liquid biopsy test can help clinicians manage difficult-to-diagnose dense breast patients

A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue. Nearly half of all women in the U.S. have dense breast tissue.

“Women who have dense breasts are at a double disadvantage. Not only are they at higher risk of developing breast cancer, but dense breast tissue can decrease the reliability of imaging and increase the chances of a false finding.” said Judith K. Wolf, MD, Chief Medical Officer of Provista Diagnostics, Inc. “This study shows that, with an over 99 percent negative predictive value (NPV), clinicians can confidently use Videssa Breast to detect cancer in women with dense breasts and better determine when biopsy is truly warranted to assess suspicious findings.”

The study, “Breast Density Does Not Impact the Ability of Videssa Breast to Detect Breast Cancer in Women Under Age 50” evaluated the performance of Videssa Breast among 545 women, ages 25 to 50, with abnormal or difficult-to-interpret imaging (BI-RADS 3 and 4). The sensitivity and specificity in the dense breast group was 88.9 percent and 81.2 percent respectively, and 92.3 percent and 86.6 percent in the non-dense group. The differences were not statistically significant. The NPV was 99.1 percent in women who had dense breasts and 99.3 in women with non-dense tissue, providing confirmation that when a woman receives a negative test result, she does not have breast cancer.

The challenges of diagnosing breast cancer in women with dense breasts has drawn national attention in recent years. Driven by patient advocacy groups such as Are You Dense Inc. and Are You Dense Advocacy, Inc., 32 states have enacted legislation to ensure women are informed of their breast density status and the associated diagnostic challenges.

A study published earlier this year in Clinical Breast Cancer proved the utility of Videssa Breast as a diagnostic complement to imaging for women with abnormal findings and demonstrated it could potentially reduce use of biopsy by up to 67 percent. “Using biomarkers for cancer detection is an important advance in managing women with dense breasts and navigating many diagnostic challenges. As a clinician, the ability to identify who will benefit most from further imaging and follow-up, and rule out breast cancer in women, when they receive suspicious findings, is tremendous,” says Elayne Arterbery, MD, radiation oncologist at St. Mary’s of Saginaw, who was a principal investigator on the Provista studies. “This study also validates the scientific promise and the growing role biomarkers have in addressing diagnostic challenges for women with dense breasts, and the merits of further research to help expand how we put that science to work to benefit women.”

Videssa Breast has been studied in two prospective, randomized, multi-center and blinded clinical trials, in more than 1,350 patients ages 25 to 75. The data featured in the current PLOS ONE publication is taken from the first study and cohort one of the second study. Videssa Breast is currently available for use by ordering healthcare providers for patients with abnormal imaging findings.

Source: https://www.sciencedaily.com/releases/2017/10/171025150623.htm

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Indian surgeons separate twins joined at the head

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Surgeons in the New Delhi, have separated twin boys who were conjoined at the tops of their heads.
Two-year-old Jaga and Kalia underwent 16 hours of surgery, and are now in the intensive care unit, doctors said.
A team of 30 doctors carried out the surgery – the first of its kind in India – at a state-run hospital.
The boys were born with shared blood vessels and brain tissues, a very rare condition that occurs once in about three million births.
The director of the All India Institute of Medical Sciences, Randeep Guleria, told the Press Trust of India that the “next 18 days would be extremely critical to ascertain the success of the surgery”.
The twins, hailing from a village in eastern Orissa state, were joined at the head – a condition known as craniopagus.
Even before the operation they had defeated the odds; craniopagus occurs in one in three million births, and 50% of those affected die within 24 hours, doctors say.
“Both the children have other health issues as well. While Jaga has heart issues, Kalia has kidney problems,” neurosurgeon A K Mahapatra said.
“Though initially Jaga was healthier, now his condition has deteriorated. Kalia is better,” he added.
Doctors said the most challenging job after the separation was to “provide a skin cover on both sides of the brain for the children as the surgery had left large holes on their heads”.
“If the twins make it, the next step will be reconstructing their skulls,” plastic surgeon Maneesh Singhal said.
The first surgery was performed on 28 August when the doctors created a bypass to separate the shared veins that return blood to the heart from the brain.

Source: http://www.bbc.com/news/world-asia-india-41772987

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