Researchers have developed a noninvasive urine test for bladder cancer

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A prospective blinded study involving 577 hematuria patients demonstrated that a new noninvasive test for bladder cancer has a sensitivity of 95 percent for higher-risk cancers and a negative predictive value greater than 97 percent.
The ADXBLADDER test, which has the potential to make noninvasive bladder testing a clinical reality, was launched at the 37th Société Internationale D’Urologie (SIU) meeting, held in Lisbon, Portugal.

“Our study demonstrates ADXBLADDER has one of the highest sensitivities and negative predictive values of any urine test for bladder cancer diagnosis,” said Stuart McCracken, who presented the results at an SIU symposium.

The new test, he added, offers innovative features, including being unaffected by urinary tract infections (UTIs), inflammation, and the presence of blood.

It is also easy to use and employs Enzyme Linked Immunosorbent assay (ELISA) technology that is readily available in most hospitals. The test requires just 10 milliliters of urine and delivers definitive “yes/no” results within 3 hours.

Current diagnostic methods
In Europe, bladder cancer represents the fourth most common cancer in men and the 15th most common cancer in women, with 151,000 people diagnosed with the condition in 2012.

In order to make a bladder cancer diagnosis, the European Association of Urology currently recommend cystoscopy for all patients with hematuria, in conjunction with CT urography (in selected high-risk patients) or renal and bladder ultrasound.

At the moment, cystoscopy cannot be replaced by cytology or any other noninvasive tests. Most bladder cancer diagnostic approaches have disadvantages; cystoscopy is an undignified, invasive, and uncomfortable procedure exposing patients to the risk of developing UTIs, which are known to occur in around 5 percent undergoing cystoscopy.

On its own, cystoscopy can miss up to 30 percent of bladder tumors and has the additional disadvantages of being expensive and having lengthy waiting lists.

Cytology is known to have a low sensitivity and its interpretation is dependent on the user, while CT urogram exposes patients to ionizing radiation.

How does ADXBLADDER work?
In the study, 577 patients attending diagnostic hematuria clinics at six centers across the United Kingdom between August 2016 and February 2017 underwent ADXBLADDER testing, with results then compared with the current diagnostic benchmark of combined cystoscopy, ultrasound, and CT scanning.

ADXBLADDER uses standard ELISA methodology to measure levels of MCM5 – that is, a protein marker of replicating cells, or cells that have the capability to replicate.
The cells that line the bladder — and which are in contact with the urine — do not contain MCM5, so urine from a healthy bladder does not contain MCM5.

All cancer cells are capable of dividing and contain MCM5. So, when a tumor is present within the bladder, these cells are in contact with urine and shed into the urine stream, which then contains the MCM5 marker.

High sensitivity and specificity
The investigators found that 7.96 percent (46) of the patients had bladder cancer, while 92.1 percent (531) did not.

When compared with the benchmark, the results showed that:

The sensitivity — that is, the ability of the test to identify patients who have bladder cancer — of ADXBLADDER in correctly detecting these cancers in high-risk and muscle-invasive groups was 95 percent (with high-risk groups at 92 percent and muscle-invasive groups at 100 percent).
The overall sensitivity for the study was 76 percent (with high-risk groups at 92 percent, muscle-invasive groups at 100 percent, intermediate-risk groups at 75 percent, and low-risk groups at 50 percent).
The overall specificity for the study was 69 percent. Specificity, which is also called the true negative rate, measures the proportion of negatives that are correctly identified as such — that is, the percentage of hematuria patients without bladder cancer who are correctly identified by ADXBLADDER as not having bladder cancer.
The negative predictive value, or the proportion of patients who test negative but who are in fact positive, was 97 percent.

Source: https://www.medicalnewstoday.com/articles/319893.php

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New Discovery: iphone – based device can detect cancer at home

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Developed by Connecticut-based start-up Butterfly Network, the pocket sized device works by shooting sound into the body and capturing the echoes
In a bid to make cancer detection easily available and timely, US researchers have developed an iPhone-based portable ultrasound machine.

The machine called Butterfly IQ can help detect cancer easily at home. It is a scanner the size of an electric razor that can display black-and-white imagery of the body, when paired with an iPhone.

Studies have previously shown that the low mortality rate due to cancer is mainly because of lack of timely detection.

Developed by Connecticut-based start-up Butterfly Network, the pocket sized device works by shooting sound into the body and capturing the echoes.

Usually, the sound waves are generated by a vibrating crystal. But Butterfly’s machine instead uses 9,000 tiny drums etched onto a semiconductor chip, reported the MIT Technology Review on Friday.

Earlier this year, John Martin, a US-based vascular surgeon and chief medical officer at Butterfly Network, discovered a cancerous mass in his own throat while testing the device.

Martin felt an uncomfortable feeling of thickness on his throat, thus he oozed out some gel and ran the probe along his neck.

On his smartphone, to which the device is connected, black-and gray images quickly appeared.

He found a 3 cm mass that was diagnosed as squamous-cell cancer – a form of skin cancer that develops in the cells of the outer layer of the skin.

Instead of vibrating crystals, Butterfly IQ uses “capacitive micro-machined ultrasound transducers”, or CMUTs, tiny ultrasonic emitters layered on a semiconductor chip a little larger than a postage stamp.

“The device gives you the ability to do everything at the bedside: you can pull it out of your pocket and scan the whole body,” Martin said.

The company now plans to combine the instrument with artificial-intelligence software that could help a novice position the probe, collect the right images, and interpret them.

By 2018, its software will let users automatically calculate how much blood a heart is pumping, or detect problems like aortic aneurisms, the report said.

The Butterfly IQ is the first solid-state ultrasound machine to reach the market in the US. The company plans to go on sale this year for $1,999-far less than any other model on the market.

Source: http://zeenews.india.com/health/now-cancer-detection-possible-at-home-iphone-based-device-developed-2052724

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Experimental vaccine may protect against HIV infection

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Scientists have developed a novel vaccine candidate that may prevent HIV infection by stimulating an immune response against sugars that form a protective shield around the virus.
Scientists have developed a novel vaccine candidate that may prevent HIV infection by stimulating an immune response against sugars that form a protective shield around the virus.

“An obstacle to creating an effective HIV vaccine is the difficulty of getting the immune system to generate antibodies against the sugar shield of multiple HIV strains,” said Lai-Xi Wang, a professor at University of Maryland in the US. “Our method addresses this problem by designing a vaccine component that mimics a protein-sugar part of this shield,” said Wang.

Researchers designed a vaccine candidate using an HIV protein fragment linked to a sugar group. When injected into rabbits, the vaccine candidate stimulated an antibody response against the sugar shield in four different HIV strains. The protein fragment of the vaccine candidate comes from gp120, a protein that covers HIV like a protective envelope.

A sugar shield covers the gp120 envelope, bolstering HIV’s defenses. The rare HIV-infected individuals who can keep the virus at bay without medication typically have antibodies that attack gp120. Researchers have tried to create an HIV vaccine targeting gp120, but had little success as the sugar shield on HIV resembles sugars found in the human body and therefore does not stimulate a strong immune response.

More than 60 strains of HIV exist and the virus mutates frequently. As a result, antibodies against gp120 from one HIV strain will not protect against other strains. To overcome these challenges, researchers focused on a small fragment of gp120 protein that is common among HIV strains. They used a synthetic chemistry to combine the gp120 fragment with a sugar molecule, also shared among HIV strains, to mimic the sugar shield on the HIV envelope.
Researchers then injected the protein-sugar vaccine candidate into rabbits and found that the rabbits’ immune systems produced antibodies that were physically bound to gp120 found in four dominant strains of HIV in circulation. “This result was significant because producing antibodies that directly target the defensive sugar shield is an important step in developing immunity against the target and therefore the first step in developing a truly effective vaccine,” Wang said.

“But the ability of the vaccine candidate to raise substantial antibodies against the sugar shield in only two months is encouraging. Other studies took up to four years to achieve similar results. This means that our molecule is a relatively strong inducer of the immune response,” he added.

Source: http://www.hindustantimes.com/health/experimental-vaccine-may-protect-against-hiv-infection/story-YF4nSGuvIivxziTsH3mYTO.html

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Health Ministry to set up ‘model lab’ in each district to fast-track diagnosis

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The move follows a health ministry review of diagnostic facilities in four states– Gujarat, Tamil Nadu, Madhya Pradesh and Jharkhand.
The Union health ministry has decided to upgrade and modernise at least one diagnostic laboratory in each district across India to fast-track diagnosis, especially during an epidemic.

These “model labs” can then be replicated across health centres and hospitals across states, which will help reduce overcrowding of tertiary care hospitals due to referrals.

“The lab of one district hospital will be upgraded with a focus on strengthening microbiology, pathology and biochemistry. States can select and choose the one they want to upgrade first and can later replicate the model in other district hospitals,” said Dr Jagdish Prasad, director general of health services (DGHS).

The move follows a health ministry review of diagnostic facilities in four states– Gujarat, Tamil Nadu, Madhya Pradesh and Jharkhand.

“The assessment report found some labs didn’t have equipment while the others did not have adequately trained staff to handle those sophisticated machines. Maintenance is also a big problem, as a result many expensive equipment lie unused and people are referred to far-off places for tests,” said Prasad.

On October 25, the DGHS reviewed technical advisory group meeting for integrated laboratories at the district level, and asked for response from the states.

The project is expected to take about six months to complete, and will be spearheaded by director National Centre for Disease Control (NCDC) and his team.

“Health is a state subject, so the project can’t materialise without taking the states on board. We have asked the states to choose districts as per their requirement. We will show them it is possible to create facilities with a limited budget and produce high-class test reports,” he says.

As part of the greater plan, the health ministry will also mentor a medical college in each state and train doctors, nurses, paramedical and technical staff, who can further train their peers in other hospitals.

“We want to standardise medical colleges and hospitals attached to them. This will be a good way to ensure all of them follow a standard protocol. All these hospitals and labs will gradually be integrated to benefit patients in the long run,” said Prasad

Source: http://www.hindustantimes.com/health/centre-to-set-up-model-lab-in-each-district-to-fast-track-diagnosis/story-maXDErnYXxq1dfqc6JjU6L.html

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Senior citizens, beware: High thyroid hormone levels can increase risk of heart disease

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A caucasian senior woman in a doctors office. She has white hair and is wearing a blue top. She is sitting in the examination room with an asian nurse holding a clipboard. She is holding a hand to her chest and looking uncomfortable. She is experiencing chest pains. The nurse is touching the patients shoulder to comfort her.

Older adults with higher levels of a thyroid hormone may be at an increased risk of artery disease and consequent death, according to new research. Free thyroxine (known as FT4) is a hormone produced by the thyroid gland that helps control the rate at which the body uses energy. Previous research linked the hormone to risk of irregular heartbeats.

The findings showed that elderly with high levels of FT4 hormone may be at twice the risk of having high levels of coronary artery calcification scores, which may be an indicator of atherosclerosis — the process of progressive thickening and hardening of the walls of arteries from fat deposits on their inner lining.

“We expected that thyroid function would influence the risk of developing atherosclerosis by affecting cardiovascular risk factors such as blood pressure. However, our results remained very similar after accounting for several cardiovascular risk factors,” said lead author Arjola Bano, from Erasmus University in the Netherlands. “This suggests that mechanisms other than traditional cardiovascular risk factors may play a role,” Bano added.
Further, increasing FT4 levels were associated with 87% greater risk of suffering an atherosclerosis-related cardiovascular event as well as double the risk of atherosclerosis-related cardiovascular death. “Our findings suggest that thyroid hormone FT4 measurement can help identify individuals at increased risk of atherosclerosis,” Bano said.

For the study, detailed in the journal Circulation Research, the team analysed data from 9,420 participants with an average age of 65. They looked at data on two types of hormones: thyroid-stimulating hormone and free thyroxine (known as FT4) and their link to atherosclerosis and death due to coronary heart disease, cerebrovascular disease or other artery-related illness.

Source: http://www.hindustantimes.com/health/senior-citizens-beware-high-thyroid-hormone-levels-can-increase-risk-of-heart-disease/story-MHyAosp0Z8nMAZncBfvgMJ.html

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Midnight Eating Habits May Increase Your Risk of Diabetes & Cardiac Issues

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Late night eating habits disrupt the working of the body’s biological clock as it is out-of-sync with the 24-hour cycle.

Are you in the habit of late night snacking? Beware, as people with this habit have a higher risk of developing various heart diseases and diabetes, says new research. Late night eating habits disrupt the working of the body’s biological clock. It is out-of-sync with the 24-hour cycle, resulting in high blood-fat levels and heart problems, the researchers found.

“The fact that we can ignore our biological clock is important for survival; we can decide to sleep during the day when we are extremely tired or we run away from danger at night,” said Ruud Buijs, Professor at the University of Mexico in Mexico City. “However, doing this frequently — with shift work, jet lag, or staying up late at night — will harm our health in the long-term, especially when we eat at times when we should sleep,” Buijs added.

The researchers studied rats who were subjected to a challenge. They were fed during the beginning of rest phase (day) and the beginning of active phase (night). The results showed that after feeding the rats at the beginning of their rest period, the level of blood fat spiked more drastically than when fed during the beginning of their active phase.

The research, published in the journal Experimental Physiology, revealed no change in the blood fat levels when the researchers removed the part of the rat’s brain that controls the 24-hour cycle. It was evident that the presence of blood fat in high levels not only affected the metabolism rate but also increased the chance of various heart diseases and diabetes.

Sorce: http://www.news18.com/news/lifestyle/midnight-snacking-may-increase-your-risk-of-diabetes-and-cardiac-issues-1570903.html

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EECP Therapy – A new, cheaper, non-invasive treatment for heart disease

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EECP- Enhanced External Counter Pulsation is gaining prominence as far treating a heart disease is concerned. It is in fact a non-invasive surgical method employed to un-block the clogged arteries and blood vessels that carry blood to the human heart. Leggings are placed within your legs which are fitted with pneumatic cuffs. Whenever the heart beat has completed a contraction the same is detected on the EECP machine and the capillaries expand and give a better passage to pump blood into the heart.

The non-surgical method is definitely cheaper when compared to a bypass surgery. The total cost of EECP is 95,000 almost one-fourth of what it costs you to do a bypass surgery. Bypass surgery is done wherein artificial stents are introduced to expand the passage of blood carrying vessels to the heart muscle. This corrects blocked arteries. But there is a significant amount of risk involved while performing the operation. The chances of survival quotient of the patient involved, gets challenged apart from being very costly.

EECP heart treatment in a nutshell

What does EECP actually do?

The patient has leggings attached in between his/her legs and these are fitted with cuffs. The cuffs inflates with every contraction and sequentially contracts with every expansion felt by the heartbeat. The opposite swings between the cuff movement and heart muscles facilitates as a form of exercise which is experienced by the body. This is the reason why symptomatic reactions of chest pain or fatigue as experienced by patients even after a bypass surgery is nullified in this method of treatment.

The treatment takes an hour each for 35 sittings. Patients are able to experience very good results with the non-invasive mode of treatment. In Bangalore itself, there are four centers for EECP wherein you can avail the treatment. Medanta in Gurgaon, Frontier Lifeline Hospital (Dr KM Cherian Heart Foundation) in Chennai, BM Birla Heart Research Centre in Kolkata and Asian Heart Institute & Research Centre in Mumbai are some of the other units offering EECP at the national level.

Few take-aways from the session and pointers to maintain a healthy and a young heart

You ladies go for a facial session at the beauty parlor to get a glowing and a youthful skin, isn’t it? What do you really do about maintaining a healthy heart? Just think about it.

Drink plenty of water to keep the body well hydrated. A well hydrated body promotes better blood circulation and the enhanced blood circulation adds to the wellness of the heart muscles as well.
Do an hour of yoga or deep breathing exercises. Practicing meditation or deep breathing gives you a relaxing effect. Most importantly it keeps the blood pressure down which is needed for the healthy functioning of the heart.
Eat a lot of fruits and vegetables especially to reduce cholesterol and to supply the body with needed nutrients and vitamins for optimal functioning of the body.
Go for nature treks once in 6 months. A visit to a hill station or so. The relaxing effect soothes the stressed muscles of the heart.
Last but definitely not the least laugh out loud. Bring out the hilarious side of you. Laughter relates to a joyful mood. When you smile 16 muscles contract while you frown the number is 52. Hence smile or laugh a lot to have a healthy heart.

Source: http://eecpindia.co.in/eecp-heart-treatment-non-invasive-methods-of-treating-heart-disease/

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Corneal donor tissue can be stored for 11 days, says study

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Donor corneas, the eye’s clear outer covering, are generally not used for surgery if they have been preserved for longer than seven days.
Corneal donor tissue can be safely stored for 11 days without negatively impacting the success of a transplant, a clinical trial has shown.

Currently, donor corneas, the eye’s clear outer covering are generally not used for surgery if they have been preserved for longer than seven days.

Expanding the window in which donor tissues can be considered suitable “by even just a few days” should help safeguard quality donor tissue and access to vision-saving transplantation procedures, the researchers said.

“The current practice of surgeons to use corneas preserved for no longer than seven days is not evidence-based.

“Rather that practice is based on opinion, which hopefully will change with this new evidence,” said lead investigator Jonathan Lass, from the Case Western Reserve University.

For the study, appearing in the journal JAMA Ophthalmology, the team looked at three-year graft success rates among a total of 1,090 individuals (1,330 eyes) who underwent cornea transplant via Descemet’s stripping automated endothelial keratoplasty by 70 surgeons at 40 surgical sites.

Overall, the three-year success rates were the same for corneas preserved for eight-to-14 days compared with up to seven days (92.1 per cent versus 95.3 per cent).

In a separate analysis, the team analysed the extent of endothelial cell loss (ECL) — the loss of cells in the corneal endothelium that continued to occur as a normal part of ageing in the grafted donor cornea three years after it had been transplanted.

They non-invasively measured ECL in the 945 eyes with successful grafts and found that corneas preserved up to seven days had a 37 per cent loss of cells versus a 40 per cent loss in corneas preserved for eight-to-14 days.

Taken together, the separate analyses looked at graft success rates and ECL support that used corneas stored up to 11 days, the researchers said.

Source: http://zeenews.india.com/health/corneal-donor-tissue-can-be-stored-for-11-days-says-study-2056202

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Breast cancer ‘can return 15 years after treatment ends’

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Breast cancer can resurface after remaining dormant for 15 years following successful treatment, a study has found.
Women with large tumours and cancer that had spread to the lymph nodes had the highest 40% risk of it coming back.
Researchers writing in the New England Journal of Medicine said extending treatment with hormone therapy could reduce the risk of it recurring.
Scientists analysed the progress of 63,000 women for 20 years.
All had the most common form of breast cancer.
This is a type fuelled by the hormone oestrogen which can stimulate cancer cells to grow and divide.
Every patient received treatments such as tamoxifen or aromatase inhibitors which block the effects of oestrogen or shut off the hormone’s supply.
Although after five years of treatment their cancers had gone, over the next 15 years a steady number of women found that their cancer spread throughout their body – some up to 20 years after diagnosis.
Women who originally had large tumours and cancer that had spread to four or more lymph nodes were at highest risk of the cancer returning the next 15 years, the study said.
Women with small, low-grade cancers and no spread to the lymph nodes had a much lower 10% risk of cancer spread over that time.

‘Remarkable’

Lead researcher Dr Hongchao Pan, from University of Oxford, said: “It is remarkable that breast cancer can remain dormant for so long and then spread many years later, with this risk remaining the same year after year and still strongly related to the size of the original cancer and whether it had spread to the (lymph) nodes.”
Doctors have long known that five years of tamoxifen reduces the risk of recurrence by about a third in the five years after stopping treatment.
Recent research has suggested that extending hormone therapy to 10 years may be more effective at preventing breast cancer recurrence and death.
Aromatase inhibitors, which only work for post-menopausal women, are believed to be even more effective.
But there are side effects with hormone treatments which can affect patients’ quality of life and cause them to stop taking the pills.
These include menopausal symptoms, osteporosis, joint pain and carpal tunnel syndrome.
Prof Arnie Purushotham, senior clinical adviser at Cancer Research UK, which funded the study, said that since the research began, new drugs had been used to treat breast cancer and those worked in different ways to tamoxifen.
He said: “It’s vital that work continues to better predict which cancers might return.
“We also need to know what the difference for women might be in taking hormone therapies for 10 years instead of five, the side effects and how this affects patients’ quality of life.”
Sally Greenbook, from charity Breast Cancer Now, said it was essential that women discussed any changes in treatment with their doctor.
“We would urge all women who have had treatment for breast cancer not to be alarmed, but to ensure they are aware of the signs of recurrence and of metastatic breast cancer, and to speak to their GP or breast care team if they have any concerns.”

Source: http://www.bbc.com/news/health-41928647

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Writing own medical record may benefit patients: study

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According to the study, published in the journal Annals of Internal Medicine, the practice may also benefit doctors by reducing time spent on documentation.
Letting people write their own medical records can help patients be more involved in the treatment, scientists say.
Researchers from the University of California, Los Angeles (UCLA) in the US found that patients could benefit if they are invited to co-produce medical notes, called “OurNotes,” with their doctors, rather than merely reading them.
According to the study, published in the journal Annals of Internal Medicine, the practice may also benefit doctors by reducing time spent on documentation.
“If executed thoughtfully, OurNotes has the potential to reduce documentation demands on clinicians, while having both the patient and clinician focusing on what’s most important to the patient,” said John Mafi, from UCLA.
“Piloting OurNotes will start at four centres in 2018,” he said.
To prepare for the pilots, the researchers conducted in-depth telephone interviews with 29 health care experts.
Participants overall believed that OurNotes could promote patient engagement, improve patient-centred care and patient-provider collaboration, and possibly take some of the documentation burdens off busy providers.
The consensus was that the most promising approach for OurNotes is to contact patients before an upcoming visit and ask them to review previous notes, provide an interval history, and list what they hope to address at the visit.

Source: http://indianexpress.com/article/lifestyle/health/writing-own-medical-record-may-benefit-patients-study-4965778/

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