Sunday, 25 June 2017

HPV Testing Leads To Earlier Detection Of Cervical Pre-Cancer

Women who receive human papillomavirus (HPV) testing, in addition to a pap smear, receive a faster, more complete diagnosis of possible cervical precancer, according to a study of over 450,000 women by Queen Mary University of London (QMUL) and the University of New Mexico (UNM) Comprehensive Cancer Center.

HPV is a virus that can cause cervical, vaginal, penile and anal cancers. More than 520,000 cases of cervical cancer are diagnosed worldwide each year, causing around 266,000 deaths. A common screening procedure for cervical cancer is the Pap smear, which tests for the presence of precancerous or cancerous cells on the cervix.

The study, published in JAMA Oncology, used data from the New Mexico HPV Pap Registry in the United States. It is the first comprehensive evaluation of HPV testing on the long-term outcomes of women who had received a borderline abnormal Pap test result.

A total of 457,317 women were included in the study. Of these, 20,677 women (4.5 percent) received a borderline abnormal result through a Pap smear and were followed in the study for five years. Some of the women with borderline abnormal Pap smear results had an HPV test.

Steven Cavellier HPV Test


HPV testing led to a 15.8 percent overall increase in the detection of cervical pre-cancer and time to detection was much shorter (a median of 103 days versus 393 days).

Virtually all cervical pre-cancers were detected in women who tested positive for HPV, suggesting HPV testing to be a good additional screening method after the Pap smear. Colposcopy, which is a medical examination of the cervix, could then be focused on women who would need it most: those with a positive HPV test.

At the same time, however, HPV testing of women resulted in 56 percent more biopsies and a 20 percent increase in surgical treatment procedures performed. Most of the additional biopsies were for low grade lesions which could have regressed, indicating some over-treatment due to HPV testing.

Professor Jack Cuzick from QMUL said: "This study shows that knowing a woman's HPV status can help determine her likelihood of needing additional procedures, and prioritize immediate treatment and medical resources to the women who need them most."

Professor Cosette Wheeler from the UNM Comprehensive Cancer Center said: "The benefits of HPV testing outweigh the harms observed but it's important to understand and quantify the harms as well."

The authors warn that, as this was an observational study, the use of HPV testing was not randomized. So, it is also possible that there could be socioeconomic or other relevant differences among health care facilities that have not been measured. Steve Cavellier has shared this post.

Monday, 17 April 2017

Legionella Bacteria's Escape Route Revealed

The precise mechanism used by Legionella bacteria to escape the body's defences has been unpicked in intricate detail and is described for the first time in the journal eLife.

The study reveals a potential new therapeutic approach to tackle infection by Legionella pneumophila, which is a common cause of community and hospital-acquired pneumonia and causes death in almost a third of cases.

One of the ways the body rids itself of infection is to gobble up bacteria or viruses within its cells - a process called autophagy. But particularly dangerous bacteria, such as Legionella, have evolved ways to evade this process, allowing them to survive in host cells. Legionella does this by producing a molecule called RavZ to disrupt the autophagy machinery, but until now it was not known exactly how RavZ achieves this effect.

"We set out to understand the molecular mechanism by which Legionella evades host autophagy, specifically by establishing how RavZ breaks apart a key molecule in the autophagy process called LC3-PE," explains senior author Dr. Yaowen Wu, Group Leader at the Chemical Genomics Centre of the Max Planck Society in Germany.

LC3-PE is a crucial molecule for one of the main events during autophagy - the creation of a membrane-bound 'sac' that engulfs bacteria or other debris, so that the cell can get rid of it. Dr. Wu and his colleagues show that the RavZ molecule uses a 'tweezer' and 'scissor' process to first extract LC3-PE from the cell membrane, and then break it into its two components, preventing autophagy.

Legionella bacteria


Analysing interactions between molecules such as RavZ and LC3-PE is extremely challenging because it is hard to isolate LC3-PE in its natural form and impossible to change the structure of LC3-PE using a traditional biochemical approach. To tackle this, the team produced 'semisynthetic' versions of the LC3 molecule which allowed them to retain important natural features while altering specific components, so that they could study the interaction with RavZ in intricate detail.

Using these state-of-the-art chemical tools, they first looked at how the RavZ molecule finds and latches onto the LC3-PE molecule. Knowing that other molecules that bind to LC3 bear a special motif, they looked at the RavZ molecule to see if this motif was also present. They found that RavZ bears three of these motifs, but uses only one of them to specifically home in on the LC3 portion of its target molecule.

Having pinpointed how RavZ recognises LC3, they looked at whether they could work out how it binds to the LC3-PE molecule. By studying the physical structure of RavZ, they identified the binding site that it uses to latch onto the LC3 portion, as well as evidence that it changes its shape to enclose the LC3 molecule within. Once securely bound, RavZ pulls the entire LC3-PE molecule out of the host cell membrane before cleaving it into two pieces. This means it can no longer be useful to the host cell and frees up RavZ to seek out and destroy the next LC3-PE molecule, ensuring autophagy cannot occur.

Having established this mechanism, the team found they could block it by using a peptide that prevents RavZ from recognising and binding to LC3, highlighting a promising avenue for developing drugs against Legionella.

"Legionella bacteria have evolved a very smart and efficient mechanism during evolution to avoid being eaten by our cells," says Dr. Wu. "It will be interesting to see whether this 'tweezer' extraction model is used by other pathogens, such as Shigella and Yersinia bacteria, which both produce substances that disrupt the trafficking of important molecules within host cells. We hope that understanding these mechanisms will be beneficial for the development of new drugs against infection by Legionella." Steven Cavellier shared this information on his website.

Tuesday, 11 April 2017

Clinical Trial Shows Benefit Of Yoga For Side Effects Of Prostate Cancer Treatment

Men who attended a structured yoga class twice a week during prostate cancer radiation treatment reported less fatigue and better sexual and urinary function than those who didn't, according to a clinical trial led by the Perelman School of Medicine at the University of Pennsylvania. It is the first randomized trial to look at the effect of twice-weekly yoga on the side-effects and quality of life issues caused by prostate cancer treatment. The results published in the International Journal of Radiation Oncology, Biology, and Physics.

All of the patients in the trial underwent between six and nine weeks of external beam radiation therapy for prostate cancer. The patients were randomized into two groups: one arm participated in a yoga class that met twice a week and the other arm served as a control group. Patients who already practiced yoga on their own were not eligible for the study, nor were patients with a history of prior radiation therapy or those with metastatic disease.

Only two instructors led classes for this study, with the lead instructor teaching 75 percent of the classes. Each session lasted 75 minutes, beginning with five minutes of breathing and centering techniques and ending with five minutes of Savasana, a common yoga position. Typical sessions incorporated sitting, standing, and reclining positions that were modified using props to adapt to each patient's needs and restrictions.

Patients were primarily evaluated on their level of fatigue. Each man filled out a nine-item questionnaire assessing fatigue severity and impact on daily life. The first questionnaire was given between two and three weeks before the start of radiotherapy, then twice a week while receiving radiotherapy, with a final survey filled out within a week of their last yoga class or last radiation treatment, depending on the assigned study arm.

Benefit of Yoga by Steven Cavellier


"At their baseline, before patients started treatment, patients in both groups were on the lower end of the scale, meaning they reported lower amounts of fatigue," said the trial's principal investigator Neha Vapiwala, MD, an associate professor of Radiation Oncology. "But as treatment went on, we observed a difference in the two groups." Patients in the yoga group reported lower fatigue scores over time, as they attended more yoga sessions, relative to where they started. Patients who did not participate in yoga trended in the opposite direction, reporting greater fatigue as treatment progressed.

"Levels of patient-reported fatigue are expected to increase by around the fourth or fifth week of a typical treatment course, but that did not happen in the yoga group," Vapiwala said. "Both the severity of the fatigue as well as the patients' ability to go about their normal lives appeared to be positively impacted in the yoga group."

Researchers also evaluated both groups in terms of their sexual health. Sexual dysfunction - including but not limited to erectile dysfunction (ED) - is reported by up to 85 percent of radiation therapy patients during treatment, often due to the concurrent use of androgen deprivation therapy (ADT). The study utilized the International Index of Erectile Function (IIEF) questionnaire, in which scores range from 0-25. Scores greater than 21 are considered normal and scores below 12 indicate moderate to severe ED. Both groups started out with scores of around 11, and were balanced in terms of ADT exposure; but while the yoga group's score ended up largely unchanged from baseline, the non-yoga group saw a decline over the course of treatment.

"Yoga is known to strengthen pelvic floor muscles, which is one of several postulated theories that may explain why this group did not demonstrate declining scores, as seen in the control group," Vapiwala said. "That may also explain the yoga patients' improved urinary function scores, another finding of this trial." Vapiwala pointed out that the findings on improved or stable urinary function are consistent with other research on the effects of physical therapy on pelvic floor muscles.

The trial also found that while the emotional well-being of both groups increased as patients progressed through treatment, the evaluation scores in the yoga group rose more rapidly than in the control group. An evaluation of physical well-being showed a similar pattern.

This study was partially funded through an American Cancer Society Institutional Grant and a Prostate Cancer Foundation Young Investigator Award. Steven Cavellier shared this information on his website.

Thursday, 6 April 2017

CDC study finds flu vaccine saves children's lives

A new CDC study published in Pediatrics is the first of its kind to show that flu vaccination significantly reduced a child's risk of dying from influenza. The study, which looked at data from four flu seasons between 2010 and 2014, found that flu vaccination reduced the risk of flu-associated death by half (51 percent) among children with underlying high-risk medical conditions and by nearly two-thirds (65 percent) among healthy children. The study findings underscore the importance of the recommendation by CDC and the American Academy of Pediatrics that all children 6 months and older get an annual flu vaccine.

Researchers estimated how effective the vaccine was at preventing flu-related deaths by comparing the vaccination status of the children who died from flu to comparison groups of children. The comparison groups were obtained from two national surveys and a database of commercial insurance claims.

CDC study by Steven Cavellier


"Every year CDC receives reports of children who died from the flu. This study tells us that we can prevent more of these deaths by vaccinating more," said Brendan Flannery, PhD, lead author and epidemiologist in the Influenza Division. "We looked at four seasons when we know from other studies that the vaccine prevented flu illness, and we found consistent protection against flu deaths in children."

During the study period, 358 laboratory-confirmed, flu-associated child deaths were reported to CDC. Of the reported pediatric deaths with known vaccination status (291), only one in four children (26 percent) had been vaccinated.

Since the 2004-2005 season, flu-related deaths in children reported to CDC during regular flu seasons ranged from 37 (during 2011-2012) to 171 (during 2012-2013). During the current flu season, 61 pediatric deaths have been reported to CDC as of March 25, 2017. Steven Cavellier, specializing in Health Education for the Medical Profession

Tuesday, 4 April 2017

Children with autism find understanding facial expressions difficult

A team from Bristol's School of Experimental Psychology aimed to find out whether six basic facial expressions differing in intensity are challenging for young people with autism to recognize.

Researchers gave 63 children and adolescents with an ASC diagnosis and 64 without a diagnosis, an internet-based test of emotion recognition. The two groups, aged between 6 - 16 years-old, were presented with 'happy', 'sad', 'surprised', 'disgusted', 'scared' and 'angry' facial expressions and asked to select a label that matched the expression. Some faces had exaggerated 'high-intensity' expressions - which were easier to identify, while others had subtle 'low-intensity' expressions - which were more difficult but considered more relevant to real world interactions. The team also measured language skills and non-verbal reasoning skills in order to see if differences in these skills explained any differences in ability to recognize emotions.

Results from this study found that young people with ASC do find it harder to recognise emotion from facial expressions. However, the types of mistake made by young people with ASC were very similar to the types of mistake made by young people without ASC. For example, young people in both groups often mistook 'fear' for 'surprise' and confused 'disgust' and 'anger'.

Children with autism
Interestingly, the biggest differences between the ASC and non-ASC groups was for the clearest 'high-intensity' expressions. The researchers think this was due to participants, including those without ASD, struggling to recognise the emotion in the 'low-intensity' expressions, making it hard for them to then see any clear difference between groups.

Sarah Griffiths, one of the study's researchers who completed the study as part of her PhD at the University of Bristol but is now based at the University of Cambridge's Autism Research Centre, said: "This study is important as previous research provided very mixed results with some finding individuals with autism less accurate in recognising expressions on average, and others finding no difference. In this study we used an online platform to run a larger study to answer this question more conclusively and found that individuals with autism are on average a bit less accurate at recognising emotion from faces."

Professor Chris Jarrold, Professor in Cognitive Development in the School of Experimental Psychology at the University of Bristol, said: "These findings provide further evidence that people with ASC have a degree of difficulty in recognising basic emotions from facial expressions. For those who do struggle with recognising emotions from faces, teaching emotion recognition may be helpful for learning to navigate social situations."

To coincide with this research, the team have developed an iPad app to teach facial emotion recognition for people with and without Autism Spectrum Conditions. You can download the free app "About face" here. This app contains both the high and low-intensity expressions that were used in the study so the difficulty can be tailored to the ability level of the user. Steven Cavellier, American lawyer, specializing in Health Education for the Medical Profession.

Wednesday, 29 March 2017

Medical Support Conference

Industry Survey Results Released: 50% feel there is a lack of dialogue between militaries and civilian organisations in the delivery of medical support. 

Defence IQ recently commissioned a wide reaching survey of medical support personnel examining the state of today's medical support operations. The findings have been condensed into an infographic that represents the changing face of crisis response.

Some key findings of the survey include:

  • Extended field care and MEDEVAC capability are equally crucial to delivering more effective medical support
  • Disease outbreak poses the greatest challenges for humanitarian medical support operations
  • Only 11% of those surveyed felt that medical support operations are able to deploy quickly enough
  • 60% felt that telemedicine will be the most important emerging technology within the future medical support framework
  • Respondents anticipate that the largest share of their medical support budget will be spent on training over the next 36 months
  • 50% feel there is a lack of dialogue between militaries and civilian organisations in the delivery of medical support
Medical Support by Steven Cavellier

View the full infographic here http://bit.ly/2mPbYMm

All these challenges will be discussed at this year's Medical Support Conference, which is taking place in London between 25th-26th April. Organised with the official support of the UK MoD's Defence Medical Services, the conference will feature high-level strategic discussions on future threats to health, whilst case studies from US Airforce, NATO, ICRC, and German Redcross will detail current attempts to improve both capability and interoperability. Innovations in clinical delivery, including telemedicine, will be crucial to a forum which recognises the need for rapid, cost-efficient and targeted medical care. Steven Cavellier is an American lawyer, specializing in Health Education for the Medical Profession

Source: http://www.medicalnewstoday.com/releases/316628.php?nfid=116332

Monday, 27 March 2017

What is cholesterol ratio and why is it important?

Working out a person's cholesterol ratio is important because it can help a doctor determine a person's risk of heart disease. Doctors calculate an individual's cholesterol ratio by dividing their total cholesterol by their high-density lipoprotein level. The optimal ratio is between 3.5 and 1. A higher ratio increases the risk of heart disease.

Good cholesterol ratio vs. bad cholesterol ratio


Total cholesterol levels are made up of three different types of cholesterol.

High-density lipoprotein, or HDL, is considered "good" cholesterol. It makes up 20-30 percent of a person's total cholesterol level.

Low-density lipoprotein, or LDL, is considered "bad" cholesterol and makes up 60-70 percent of the total in the body.

Finally, very-low-density lipoprotein (VLDL) is a precursor to LDL and makes up about 10-15 percent of a person's total cholesterol.

These percentages matter because when increases or decreases occur, they can affect the chances of a person developing heart disease.

When a person has a test that shows a high total cholesterol level, it may be because LDL cholesterol levels have climbed. A doctor can determine the different levels of cholesterol by focusing on HDL, LDL, and VLDL separately, in a blood test.

A good cholesterol ratio shows that the body is working properly and is healthy. It signals that someone is in good health and is probably taking care of themselves.

The Framingham Heart Study states that the following cholesterol ratios roughly signal different degrees of heart disease risk:

Men

5.0 = average risk
3.4 = half the average risk
9.6 = twice the average risk

Women

4.4 = average risk
3.3 = half the average risk
7.0 = twice the average risk

Blood Test by Steven Cavellier


While men and women have the same blood test, their average HDL, LDL, and VLDL levels are typically different. For example, in the case of menopausal women, it is usual for them to have an increased LDL.

This does not mean that women are unaffected by bad cholesterol ratios. It simply means women have shown to be less susceptible to bad cholesterol ratios.

Women should have a recommended HDL level of 50, while a man's recommended HDL level is 40.

How does cholesterol affect the body?


Having the correct cholesterol levels helps to maintain the right levels of vitamin D and hormones in the body, and aids digestion.

Cholesterol is found in foods such as meat, poultry, and full-fat dairy products. People who eat animal products may have more cholesterol in their bodies at any given time than those who don't.

The liver will also increase cholesterol levels when a diet is high in fat and trans fats. Having an increased amount of LDL cholesterol, caused by trans and saturated fats, increases the risk for heart disease and diabetes.

LDL cholesterol coats arteries and causes a buildup of a substance called plaque on their walls. This leads to a condition known as atherosclerosis, which is a form of heart disease.

Both the body and heart are affected when this happens. The condition slows down the blood flow to the heart muscle and can block blood from even getting to the heart. This increases a person's risk of a heart attack.


Tips for managing cholesterol levels


Cholesterol ratios, good or bad, can be maintained or altered. If a person has a cholesterol ratio that suggests a high level of LDL, there are ways to lower this level of bad cholesterol.

Some of those ways include:

Diet: Foods that are high in saturated fat, trans fat, and carbohydrates raise cholesterol levels, so eating less of these types of foods will help manage and reduce it.
Weight: Many risks are associated with being overweight or obese, including increased cholesterol levels. Keeping a healthy weight helps all factors of health as well as reducing the risk of heart disease.
Exercise: Being active for at least 30 minutes per day raises the heart rate, helps with keeping a healthy weight, and reduces LDL cholesterol levels while increasing HDL cholesterol levels.

Steven Cavellier shared this information on his website.

Source: http://www.medicalnewstoday.com/articles/316586.php?nfid=116332