Saturday, 12 March, 2005, 23:57 GMT

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Oily fish helps cut inflammation
(inflammation: /infla'meiSn/ n. redness and heat in a part of the body)



Scientists have discovered why a diet high in oily fish like salmon and mackerel may help improve inflammatory conditions such as arthritis.
They have found a key anti-inflammatory fat in humans is derived from a fatty acid found in fish oil.

The researchers, from Harvard Medical School and Brigham and Women's Hospital, found the diet worked best when combined with low aspirin doses.

Details are published in the Journal of Experimental Medicine.

Since we obtained these results I started to encourage my own children to eat foods rich in omega-3 fatty acids

Dr Charles Serhan

The inflammatory response protects the body against infection and injury, but when it goes wrong it can lead to conditions such as arthritis, and cardiovascular disease.

The Harvard team identified a new class of fats in the human body, called resolvins, which they showed can control inflammation.

They do this both by stopping the migration of inflammatory cells to sites of inflammation, and the turning on of other inflammatory cells.

Resolvins are made from the omega-3 fatty acids, found in high concentration in oily fish.

Their production also appears to be stimulated by taking aspirin.

One form of resolvin - E1 - is thought to play a particularly significant role in controlling inflammation.

The researchers identified this specific fat in blood plasma samples taken from volunteers given omega-3 fatty acids and aspirin.

Lead researcher Dr Charles Serhan told the BBC News: "Since we obtained these results I started to encourage my own children to eat foods rich in omega-3 fatty acids."

Drug concern

The study also reveals a potential pitfall of COX-2 inhibitors, drugs designed to block inflammation, which have been shown to have negative cardiovascular side effects.

The enzyme COX-2 is involved in making resolvin E1, and the researchers suspect that taking the drugs may disrupt the body's ability to synthesise the fat.

Thus, while the drugs are designed to reduce inflammation, it is possible that they actually undermine one of the body's most important methods for achieving the same effect.

However, the researchers stress the experiment to prove this idea has yet to be done with humans.

A spokesperson for the Arthritis Research Campaign said: "A number of studies have suggested that oily fish can help people with inflammatory arthritis, and this new study appears to confirm this.

"Our charity has also funded a small preliminary study which shows that oily fish or fish oil capsules can also play a part in reducing the pain and inflammation in osteoarthritis - a degenerative type of arthritis.

"We always suggest that people with arthritis eat two or three portions of oily fish a week, or take 1,500mg fish oil capsules a day."

http://news.bbc.co.uk/2/hi/health/4325679.stm

Monday, 14 March, 2005, 00:10 GMT

Key to severe skin disease found

Hi-tech genetic analysis was used
Scientists have discovered a gene responsible for a devastating and life-threatening skin disease.
.

Affected families Key to severe skin disease found

The researchers looked at individuals from 12 families affected by HI.



Using SNP array technology, they were able to pinpoint a suspect area of the genetic code linked to activity of a gene called ABCA 12.



New treatments

Lead researcher Professor David Kelsell said: "The condition is extremely devastating, HI babies are in critical condition from birth being very susceptible to infection and other complications - the reason why many die.

He said that with excellent intensive care, HI babies could survive.

Family planning

There are HI children in their late teens living life as normally as possible with their condition.

"Second, once the function of this gene is described, new, logical, molecularly-targeted approaches to therapy become possible."

http://news.bbc.co.uk/2/hi/health/4337009.stm

http://story.news.yahoo.com/news?tmpl=story&u=/050322/photos_lf_afp/050322074533_zb0x8h2b_photo0

http://story.news.yahoo.com/news?tmpl=story&cid=1548&ncid=1548&e=3&u=/afp/20050322/lf_afp/afplifestyleindiateapill

U.N.: War on TB Succeeding in Most Places

Thu Mar 24,11:36 AM ET Health - AP

By EMMA ROSS, AP Medical Writer

LONDON - Most areas of the world seem to be winning the battle against tuberculosis, but an overwhelming burden of cases in Africa, unleashed by HIV (news - web sites), is frustrating efforts to reverse the global epidemic, according to a new U.N. report.

http://www.stoptb.org

http://story.news.yahoo.com/news?tmpl=story&cid=541&ncid=541&e=3&u=/ap/20050324/ap_on_he_me/global_tb_war

World TB Day: 24 March 2005
By Joe De Capua
Washington
24 March 2005


Today is World TB Day – a day set aside each year to draw attention to a disease that kills about two million people annually. In sub-Saharan Africa, the high prevalence of HIV/AIDS makes the battle against tuberculosis even tougher to win.

TB is a bacterial disease that can attack any part of the body, but usually hits the lungs the hardest. It’s spread through the air when a person infected with tuberculosis bacteria coughs or sneezes.\



Marcos Espinal is executive secretary of the Stop TB Partnership.

"Two billion people, or one-third of the world population, carry the bacteria that develop TB as a disease. That’s to start with, infections. Nine million every year develop the disease, nine million new cases of tuberculosis worldwide of which two million die of the disease every year," he says.

The disease is concentrated in 22 countries, mainly in Africa and Southeast Asia.

"I can tell you the top five countries are China, India, Indonesia, Nigeria and Bangladesh," he says.

A UN report indicates TB cases are rising 3 to 4 percent a year across Africa.

The US Centers for Disease Control says not everyone who breathes in the bacteria develops TB. In fact, most people’s immune systems are able to fight the germs and keep them from growing. This is called latent TB and it may or may not develop into the disease later on.

But if the immune system is weak the bacteria can multiply. For example, the CDC says babies and young children have weak immune systems, as do people with HIV/AIDS.

Mr. Espinal of the Stop TB Partnership says TB and HIV are closely linked.

"Oh, it’s a marriage. I call it marriage without divorce, basically. I can tell you the latest

report of the WHO released yesterday in London shows that the incidence of tuberculosis is declining in five of the six continents in the world, except in Africa due to the co-infection, joint infection of TB and HIV," he says.

He says in countries such as South Africa and Botswana, half of those infected with TB also have HIV, the top two killer diseases in the world. But Mr. Espinal says TB is also a disease of poverty.

"It’s a disease that affects those who don’t have access to food, to good living conditions, to medicines. And it has been a neglected disease for many years," he says.

Tuberculosis in the lungs has some obvious symptoms, including a bad cough lasting more than two weeks, coughing up blood or phlegm and chest pain. Other symptoms include weakness, chills, fever and weight loss. Those who have latent TB show no symptoms and do not spread the disease.

A simple skin test is done to detect tuberculosis and Mr. Espinal says treatment is available.

"Well, we have a very highly efficacious treatment. It’s called short course chemotherapy. It’s a combination of four drugs that the patient should take for six to nine months. It cures more than 85 percent of all those who take the drugs properly," he says.

The international strategy to fight the disease is called DOTS. It calls for government commitment, diagnosis, standard short-course therapy, a steady supply of quality drugs and the recording and reporting of all TB patients.

Several initiatives are underway to develop new drugs to cure TB more quickly, better diagnostic tools and a vaccine. The Global Alliance for Drug Development, based in New York, is leading the effort.

The Stop TB Partnership is a coalition of 300 institutions worldwide and hosted

http://www.voanews.com/english/Africa/2005-03-24-voa28.cfm

Yahoo! News Sun, Mar 27, 2005

New Compound May Prevent Allergies, Study Finds

2 hours, 16 minutes ago

WASHINGTON (Reuters) - A new chemical compound, part-cat and part-human, may provide an end to misery-making cat allergies, U.S. researchers reported on Sunday.

And they said their approach in creating the compound may work against more dangerous allergies, such as deadly peanut allergies.

The compound, tested in mice bred to be allergic to cats, virtually shut down the histamine reaction that causes the uncomfortable symptoms of cat allergies such as runny eyes, sneezing and itching, Dr. Andrew Saxon of the University of California Los Angeles School of Medicine and colleagues reported.

Writing in the April issue of Nature Medicine, they said their compound also worked in human cells grown in lab dishes.

"This novel approach to treating cat allergies is encouraging news for millions of cat-allergic Americans. Moreover, these results provide proof-of-concept for using this approach to develop therapies to prevent deadly food allergy reactions as well," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (news - web sites), which paid for the study.

Allergies are caused when the immune system mistakenly reacts to allergens -- pieces of protein found in food, on animals or produced by plants. One response is the production of histamine, which brings on allergy symptoms such as sneezing, wheezing, itching, watery eyes and sometimes asthma.

The compound stops this process. It uses pieces of an allergy-provoking protein found in cat saliva or dander called Fel d1, tied to a piece of human antibody called IgG Fcg1. The UCLA team named it GFD, or gamma Feline domesticus.

The cat allergen part attaches to antibodies on the surface of the immune system cells that produce histamine, while the human bit stops the cell from getting started.

"We measured more than 90 percent less histamine in the (human cell) cultures with GFD," Saxon said. "Those results suggested that GFD successfully prevented the immune cells from reacting to cat allergen. The next step was to test GFD in mice that we had made allergic to the allergenic protein found in cat saliva and dander."

The researchers tested GFD in two types of allergic mice, and it blocked the immune over-response in both.

The approach could be used to protect people from a wide array of allergies, the researchers said.

http://story.news.yahoo.com/news?tmpl=story&u=/nm/20050327/hl_nm/health_allergies_dc

Health Benefits Help Peanuts Shed Stigma

Yahoo! News Sun, Apr 03, 2005
2 hours, 23 minutes ago Health - AP

By ELLIOTT MINOR, Associated Press Writer

ALBANY, Ga. - Peanuts, a dietary outcast during the fat-phobic 1990s, have made a comeback, with consumption soaring to its highest level in nearly two decades and more doctors recommending nuts as part of a heart-healthy diet.

When peanut butter and snack peanuts plummeted as Americans switched to lowfat diets, the peanut industry responded with studies showing the health benefits of peanuts. Total consumption of peanuts jumped last year to nearly 1.7 billion pounds, compared to 1.5 billion pounds the year before.

The amount of snack peanuts eaten climbed to 415 million pounds in the 2003-2004 crop year, the highest since the mid-1990s. And peanut butter consumption soared to 900 million pounds, from a low of about 700 million in the '90s.

"Mothers gave us peanuts and peanut butter. Now, we've figured out that Mom was right. But it took a lot of researchers and universities to figure that out," said Don Koehler, executive director of Georgia's Peanut Commission.
......

http://story.news.yahoo.com/news?tmpl=story&cid=541&ncid=541&e=1&u=/ap/20050403/ap_on_he_me/fit_peanuts_rebound

Too Much Water May Be Deadly for Athletes

Thu Apr 14, 7:15 AM ET Health - AP

By LINDA A. JOHNSON, Associated Press Writer

Runners, hikers, bikers, even soldiers on long maneuvers should think twice before reaching for that water bottle: A study confirms that drinking too much can be dangerous, even deadly, for endurance athletes.

Researchers who studied 488 runners in the 2002 Boston Marathon found that 62, or more than one in eight, had a serious fluid and salt imbalance from drinking too much water or sports drinks. Three of them had extreme imbalances.

One 28-year-old woman died after the race from the condition, called hyponatremia, in which the excess water dilutes the salt level in the body too much.

"More is definitely not better when it comes to fluids, but it's a hard message to get across," said Leslie Bonci, director of sports nutrition at Pittsburgh Medical Center.

Endurance athletes have long been warned about getting dehydrated, and many tend to drink more on race day than they do during training.

The study was reported in Thursday's New England Journal of Medicine.

The researchers, led by Dr. Christopher Almond, a cardiologist at Harvard Medical School and Children's Hospital Boston, tested Boston Marathon runners' blood after the race and collected information on their condition, race time and liquid intake.

They found hyponatremia was most serious in runners who gained substantial weight — 4 1/2 pounds to 11 pounds — from drinking lots of water along the route. Extremely thin runners also were at high risk. Runners who drank sports drinks, which contain very little salt, were not less likely to develop hyponatremia.

Bonci and Almond said a good way to prevent problems is for athletes to weigh themselves before and after training sessions. If they gain significant weight, they should cut back on water intake until they find the right balance — long before race day.

The goal is simply to replace water lost to sweating.

Hyponatremia can begin with confusion and lethargy and progress rapidly to twitching, seizures, stupor, coma and death.

Severe cases are believed to have become more common with the growing popularity of endurance sports. In recent years, hyponatremia has killed several amateur marathon runners, as well as competitors in the Marine Corps Marathon.

This year's Boston Marathon will be on Monday.

http://news.yahoo.com/news?tmpl=story&u=/ap/20050414/ap_on_he_me/fit_athletes_water

1. Back Pain - Types and Diagnosis

... Back Pain - Types and Diagnosis When you feel pain, it is really a reaction to signals transmitted throughout......When acute back pain is severe and travels down both legs, it could be caused by lumbar disc disease - the most common cause of true sciatica, another form of acute pain....
In: Diseases & Conditions: Back Pain

2. The Lumbar Spine

... The Lumbar Spine Physicians use a code to number each of the 24 vertebrae in the spine.......The lumbar vertebrae, L1-L5, are most frequently involved in back pain because these vertebrae carry the most amount of body weight and are subject to the largest...
In: Diseases & Conditions: Back Pain

3. What Causes Back Pain?

... What Causes Back Pain?......Strains Despite their size and strength, muscles of the lumbar spine can rip or tear....
In: Diseases & Conditions: Back Pain

4. Radiculopathy - Pain Caused by Nerve Roots

... Radiculopathy - Pain Caused by Nerve Roots Radiculopathy Doctors use the term radiculopathy to specifically describe...... disease is often caused by direct pressure from a herniated disc or degenerative changes in the lumbar spine that cause irritation and inflammation of the nerve roots....
In: Diseases & Conditions: Back Pain

5. Sciatica - Pain From The Sciatic Nerve

... Sciatica - Pain From The Sciatic Nerve Sciatica refers to pain that begins in the hip and buttocks and continues......True sciatica is a condition that occurs when a herniated lumbar disc compresses one of the contributing roots of the sciatic nerve....
In: Diseases & Conditions: Back Pain

.....

5. Sciatica - Pain From The Sciatic Nerve

... Sciatica - Pain From The Sciatic Nerve Sciatica refers to pain that begins in the hip and buttocks and continues......True sciatica is a condition that occurs when a herniated lumbar disc compresses one of the contributing roots of the sciatic nerve....
In: Diseases & Conditions: Back Pain

6. Low Back Pain

... Low Back Pain Definition Pain in the spine or muscles of the lower back.......Alternative Names Backache; Low back pain; Lumbar pain; Pain - back Considerations Low back pain usually involves spasm of the large,...
In: Diseases & Conditions: Back Pain

7. Anterior Lumbar Interbody Fusion

... Anterior Lumbar Interbody Fusion What is it?......Patients who are suffering from back and/or leg pain are potential candidates for the ALIF procedure....
In: Diseases & Conditions: Back Pain

8. Lumbar Spinal Surgery

... Lumbar Spinal Surgery Definition Surgery to correct problems with the spinal bones (vertebrae),......Pressure on the nerves that branch off of the spinal cord can produce pain, numbness, tingling, or weakness and may be caused by: injured disks that bulge out (slipped...
In: Diseases & Conditions: Back Pain

9. Lumbar Laminectomy

... Lumbar Laminectomy What is it?...... a nerve root in the lower spine, often called nerve root compression, causes back and leg pain....
In: Diseases & Conditions: Back Pain

10. Lumbar Microdiscectomy

... Lumbar Microdiscectomy What is it?...... surgery is recommended when a ruptured disc is pinching a spinal nerve root(s) and you have: Leg pain which limits your normal daily activities Weakness in your leg(s) or feet Numbness in your...
In: Diseases & Conditions: Back Pain

Liver May Be Prime Source of Good Cholesterol

Thu Apr 28, 7:03 PM ET

THURSDAY, April 28 (HealthDay News) -- About 80 percent of the "good" high-density lipoprotein cholesterol produced by the body comes from the liver -- a finding that may lead to new ways to increase HDL levels, new research suggests.

Low levels of HDL are associated with a higher risk of heart attack.

Results of the study, conducted on mice, will be published in the May issue of the Journal of Clinical Investigation.

Researchers genetically engineered mice that lacked the ABCA1 gene in the liver, which meant that their livers could not produce HDL. The mice had HDL levels 80 percent lower than normal mice.

"In studies of mice, we provided the first definitive proof that the liver is the source of about 80 percent of the high-density lipoprotein, or 'good' cholesterol, that circulates in the blood," senior researcher John S. Parks, professor of pathology at Wake Forest University School of Medicine, said in a prepared statement. "Understanding more about how HDL is produced could lead to new treatments to raise its levels."

It was previously believed that HDL production occurred throughout the body. Some HDL production does occur in the walls of blood vessels.

"These results profoundly alter our concept of how HDL is manufactured in the body and establish the liver as the single most important source of HDL in a mouse model," Parks said.

More information
The American Heart Association has more about HDL.

http://news.yahoo.com/s/hsn/20050428/hl_hsn/livermaybeprimesourceofgoodcholesterol

Schoolyard Prank Puts Students at Risk for HIV

ABC News

PHILADELPHIA, April 29, 2005 -- Parents of some children at an elementary school are afraid that the youngsters may have been exposed to the virus that leads to AIDS after as many as 19 third-graders, including one who is HIV positive, were pricked by the same needle.

......

As of Thursday evening, the parents of five children said the test results were negative for the potentially deadly virus. The children will be tested twice more.

http://abcnews.go.com/Health/story?id=714244&page=1

May 20, 2005 - Published 23:51 GMT



Smallpox is one of the deadliest diseases the world has ever known. It kills over a quarter of all of those infected with it. Those who survive are left disfigured and often blind.

As late as the 1960s smallpox claimed over two million lives a year, but it was finally eradicated in 1977, a success for the World Health Organisation.

The next step, to destroy all remaining laboratory samples of the virus was promised, but never taken.

The proposal for genetic modification involves inserting a fluorescent protein into the virus. It will glow green if the virus is alive, but won't show if it is dead, so it is claimed it is a fast and safe test for antivirals.

Critics of this research don't agree. They say it will open a Pandora?s box of genetic manipulation of dangerous viruses and may even end up defeating the WHO's stated purpose, which is to be ready with treatment should smallpox be released. They point out that the last person to die from smallpox did so after the virus escaped from a laboratory and they say the only real way to protect the world from this disease is to destroy it once and for all.

Imogen Foulkes, BBC News, Geneva

http://www.bbc.co.uk/vietnamese/learningenglish/witn/2005/05/050518_smallpox.shtml

FDA Looking Into Blindness-Viagra Link

By LAURAN NEERGAARD, AP Medical Writer
52 minutes ago


WASHINGTON - Federal health officials are examining rare reports of blindness among some men using the impotence drug Viagra

The Food and Drug Administration still is investigating, but has no evidence yet that the drug is to blame, said spokeswoman Susan Cruzan.

This type of blindness is called NAION, or non-arteritic anterior ischemic optic neuropathy. It can occur in men who are diabetic or have heart disease, the same conditions that can cause impotence and thus lead to Viagra use.

The FDA has 50 reports of the blindness. Viagra has been taken by more than 23 million men worldwide.

"We take this seriously," said FDA's Cruzan.

On its Web site, Viagra manufacturer Pfizer Inc., states: "The most common side effects of Viagra are headache, facial flushing, and upset stomach. Less common are bluish or blurred vision, or being sensitive to light. These may occur for a short time." That language had been available before the current inquiry.

Pfizer spokesman Daniel Watts confirmed Friday that the drugmaker was in discussions with the FDA about adding a disclosure to Viagra's label to say that in rare cases, men taking Viagra had developed blindness. However, he said there is no proof that Viagra caused the blindness. He said that men who take Viagra often have high blood pressure and high cholesterol, which are also associated with the conditions that can cause blindness.

FDA is working with Pfizer to determine what, if any, information about the condition should be added to the drug's label. The story was first reported by CBS News.

Viagra was approved by the government in 1998. It may aid in the treatment of enlarged hearts that can result from high blood pressure, tests on animals indicate.

Viagra, approved to treat erectile dysfunction, should not be used by men with heart conditions whose doctors have warned them not to have sex. Also, patients taking drugs that contain nitrates have been warned not to take Viagra because of sudden, unsafe drops in blood pressure.

The drug's label also warns of erections lasting longer than four hours, painful erections lasting longer than six hours, headache, flushed skin and vision problems.

Pfizer Inc., the New York-based maker of Viagra, said in its most recent quarterly filing with the Securities and Exchange Commission that sales of the drug rose 5 percent — to $438 million in the first quarter of the year. Pfizer also said at the time that Viagra had a 68 percent worldwide market share.

___

On the Web:

http://www.viagra.com/getTheMost/index.asp

http://www.fda.gov


http://news.yahoo.com/s/ap/20050527/ap_on_he_me/viagra_blindness

Peru Doctors Separate 'Mermaid' Baby Legs

By MONTE HAYES, Associated Press Writer
4 minutes ago

LIMA, Peru - Doctors fully separated the fused legs of a baby girl known as Peru's "mermaid" early Wednesday, calling the delicate procedure a "true success."
......
Rubio said Milagros would need up to 15 years of corrective surgeries to reconstruct and repair her sexual, digestive and other internal organs.

http://news.yahoo.com/news?tmpl=story&u=/ap/20050601/ap_on_he_me/peru_mermaid_baby

Thursday, 2 June, 2005, 14:29 GMT 15:29 UK

'Mermaid' girl may walk - doctors


A girl born in Peru .

.....

Poor family

Most sirenomelia sufferers have severe organ damage and die within hours.

....

However, the costs of the operation are being met by the city of Lima, whose mayor is the girl's godfather.

http://news.bbc.co.uk/2/hi/americas/4603345.stm

STAGES OF SEPARATION PROCEDURE



1 - Legs are fused together by skin and feet splayed in a V-shape
2 - Saline sacks inserted and gradually filled to stretch the skin
3 - Legs separated, using the stretched skin to cover the wounds
4 - A later operation will rotate splayed feet forward


Thursday, 2 June, 2005, 14:29 GMT 15:29 UK
http://news.bbc.co.uk/2/hi/americas/4603345.stm

Tuesday, 4 October 2005, 11:24 GMT 12:24 UK

Doctors back conjoined twins op



A leading US neurosurgeon says an operation on 10-year-old conjoined twins in India, Farah and Saba, can go ahead if their parents consent.
Dr Benjamin Carson of Johns Hopkins Children's Center in Baltimore will carry out the surgery if the girls' family gives permission.

The operation would take place at the private hospital in Delhi where the twins have been undergoing tests.

Conjoined twins are rare, occurring in about one in every 200,000 births.

The girls, who are joined at the head, have been examined at Delhi's Apollo Hospital.

Dr Carson decided that the 10-year-old twins could be separated after carrying out a series of tests at the hospital.

Of course, there are risks involved

Anjali Bissell, hospital spokeswoman


In pictures: Indian twins
Conjoined twins explained
Ethics of separating twins

"Dr Carson is staging the whole surgery process," Anjali Kapoor Bissell, spokeswoman for Apollo Hospital told reporters.

"He thinks it would be possible to have the surgery.

"Of course, there would be risks involved. All this is dependent on counselling and consent from the family," Ms Bissell said.


Complications


The twins are joined at the head and share an artery that carries blood to their hearts and a blood drainage vessel in the brain.




An added complication is that one of the girls, Farah, has two kidneys while Saba has none and will require a kidney transplant.

"We have given time to the parents to mull it (the operation) over and make an informed decision," hospital paediatrician Anupam Sibal told reporters.

Dr Carson was flown in after Abu Dhabi's crown prince, Mohammed bin Zayed Al-Nahyan, agreed to bear the costs of any operation.

The head of paediatric neurosurgery at Johns Hopkins Children's Center, and a team of doctors conducted a brain angiography to determine the extent to which the girls share the vein that supplies blood to their brain.

Doctors say any operation would involve grafting a vein from another part of the body.

The girls' father, Mohammad Shakeel Ahmad, told the BBC that he was hoping for a miracle.

Mr Ahmad, a restaurant-owner in the northern state of Bihar, does not have enough money to pay for an operation.

Survival rates


Conjoined twins originate from a single fertilised egg, so they are always identical and of the same sex.




The overall survival rate of conjoined twins is somewhere between 5% and 25%.

Historical records over the past 500 years detail about 600 surviving sets of conjoined twins with more than 70% of those surviving pairs resulting in female twins.

If they have separate sets of organs, the chances for surgery and survival are greater than if they share the same organs.

Dr Carson was the lead neurosurgeon of a 70-member team that successfully separated seven-month-old German twin boys in 1987.

In 1997, he and a team of 50 doctors separated 11-month-old Zambian boys, both of whom survived.

The specialist was also a member of at least three other attempts to separate conjoined twins, including the unsuccessful 2003 operation on Laleh and Ladan Bijani, 29-year-old twins from Iran.

http://news.bbc.co.uk/2/hi/south_asia/4305954.stm

Separation of twins possible, say doctors

Staff Reporter

The envisaged surgery, a complex six-stage procedure, involves massive restructuring and grafting

NEW DELHI: It all came down to the angiography.

The procedure, supervised by Benjamin S. Carson, Professor and Director, Paediatric Neurosurgery, Johns Hopkins Children's Centre, validated the conclusion of the 60-odd physicians at Delhi's Indraprastha Apollo Hospital and Johns Hopkins Children's Centre in Baltimore — that the separation of the 10-year-old conjoined twins, Sabah and Farah Shakeel, was possible.

Kidney transplant


The envisaged surgery, a complex six-stage procedure, would continue through the autumn of next year and involve massive restructuring and grafting. A major concern would be the separation of the brain circulatory system and the kidney transplant after the separation of the twins.

A final decision on the surgery would, however, be taken by the Patna-based parents, who have decided to wait till Ramzan.

Twins conjoined at the head, called carniopagus, are extremely rare and their incidence is one in two million births. The twins, who came to Delhi last Saturday, underwent tests to gauge the risk involved in separating them.

At a press conference on Tuesday, Anupam Sibal, group medical director and senior child specialist, Apollo Hospitals, said, "The surgery is possible and the combined team of Apollo and Johns Hopkins can do it."

Stating that a "tentative" procedure had been chalked out, Dr. Carson said, "The separation would require multiple steps and multiple surgeries. For the surgery, the first step would be to make a virtual reality model to conduct mock exercises before the actual separation of the twins. Three months later, a test occlusion will be carried out for redistribution of the vascular supply of the brain. This would be followed by distraction of the blood vessel after about two weeks to allow the individual brain cells to start the process of separation."

Skin deficit


"The next stage would involve the expertise of plastic surgeons to make up for any skin deficit after this surgery. Following this, it will take about three months before we arrive at a fixed date for the actual separation. Further, renal transplant will also be undertaken for Sabah who in the absence of a kidney is totally dependent on Farah for the same," he said.

Rising blood pressure


Highlighting the fact that surgery was "important" to give the twins a fair chance at leading a full life, Dr. Carson, who has conducted five of the 10 recorded surgeries on such twins across the world, said, "One of the twins is already displaying symptoms of stress on her heart and also rising blood pressure. Also, with the shared kidney, the chances of the children leading a healthy life is compromised."

The cost of evaluations and "possible surgery" was being funded by the Crown Prince of Abu Dhabi, Sheikh Mohammed Bin Zayed Al Nahayan, who approached the girls' father through the UAE Embassy here.

Apollo Hospitals has established a separate "Sabah and Farah Fund" to support the needs of the family and to compensate for the prolonged loss of livelihood due to their stay in Delhi for surgery.

http://www.hindu.com/2005/10/05/stories/2005100508571400.htm

>>>>>>>>>>>>

BBC NEWS: VIDEO AND AUDIO
See Saba and Farah before their operation


http://news.bbc.co.uk/2/hi/south_asia/4305954.stm#

Exercise amount more important than intensity
Tue Oct 11, 9:09 AM ET



NEW YORK (Reuters Health) - How much you exercise may be more important than how hard you exercise in terms of heart health, according to a study of sedentary overweight men and women. And, many will be happy to hear, exhaustive amounts of exercise are not needed for heart health.

In journal CHEST, researchers from North Carolina report that people who walk briskly for 12 miles per week or for about

125 to 200 minutes per week will significantly improve their aerobic fitness and lower their risk of developing heart disease.

"Anything beyond walking briskly for 12 miles per week, whether increasing your intensity or the amount of miles, has additional benefits," Brian D. Duscha from Duke University Medical Center in Durham who was involved in the research said.

"So there is a separate and combined effect."

He also emphasized that the 12-miles-per-week walkers in the study improved their fitness without losing any weight. "People need to know: even without losing weight, you are getting significant benefits by exercising -- you're improving your fitness level, decreasing fat and increasing muscle and improving your lipid panel -- so don't stop exercising," Duscha

said.

"The other thing to realize is that people gain 3 to 4 pounds a year, so exercise is really important for weight maintenance," Duscha said.

There is a clear link between heart health and fitness. However, less is known on how the amount and intensity of exercise relates to increases in fitness for individuals at risk for heart disease.

To better understand the effects of different amounts of exercise on aerobic fitness, Duscha and colleagues randomly assigned 133 overweight sedentary men and women showing signs of rising cholesterol levels to 7 to 9 months of no exercise; low amount/moderate intensity exercise (the 12-miles per week walkers); low amount/vigorous intensity (12 miles of jogging per week); or high amount/vigorous intensity (20 miles of jogging per week).

The study subjects did not alter their diet during the study.

After completing their exercise assignment, all of exercisers had improvements in peak oxygen consumption and time

to exhaustion -- two established markers of fitness - compared

with levels at the beginning of the study.

Interestingly, however, the vigorous intensity exercisers did not get any "fitter" than the moderate intensity exercisers. "The moderate intensity group only exercised to 40 or 50 percent of their max," Duscha explained. "That's walking briskly up a hill or walking fast -- you could walk around the neighborhood after dinner and get that in. You don't have to go

jog, climb on the stairmaster or elliptical trainer and kill yourself."

However, increasing the amount of exercise from 12 to 20 miles per week -- at the same intensity -- provides even more cardiovascular benefits.

"Therefore," Duscha and colleagues conclude, "it is appropriate to recommend mild exercise to improve fitness and reduce cardiovascular risk, yet encourage higher intensities and amounts for additional benefits."

SOURCE: Chest, October, 2005.

http://news.yahoo.com/s/nm/20051011/hl_nm/exercise_dc

Doctors back conjoined twins op
Post: #34

Indian conjoined twins may soon be separated
U.S. surgeon believes 10-year-olds could survive skull surgery



Conjoined twins Saba, left, and Farah look on during a press conference at the Indraprastha Apollo Hospital in New Delhi, India, Tuesday. U.S. neurosurgeon Dr. Benjamin Carson said he believes the 10-year-old twins joined at the skull can be successfully separated.

5th Nov 2005 : Web Edition No: 12336

US surgeon to separate 2 sets of Siamese twins in India


NEW DELHI (AFP): The US neurosurgeon who hopes to separate two Indian girls who are joined at the head is also willing to operate on a second set of Siamese twins from southern India, a hospital official said Friday.“We heard about them through the media and we would want to collaborate with the team down there,” said Anupam Sibal, medical director of New Delhi’s Apollo Hospital.Two days after the Apollo announced plans Tuesday to go ahead with an attempt to separate twins Sabah and Farah Shakeel if their parents consent, the Times of India reported another case in Andhra Pradesh state.Like the 10-year-old Shakeels, Veena and Vani, aged two, are joined at the head and share a major blood drainage vessel in the brain.

Dr Benjamin Carson, head of pediatric neurosurgery at Johns Hopkins Children’s Center in Baltimore, Maryland, has agreed to operate on Sabah and Farah, risky as the operation may be.The Apollo hospital has been in touch with the hospital in Andhra Pradesh that is caring for twins Veena and Vani.“Dr Carson has dedicated his life to the cause of conjoined twins,” Sibal said. “In place of one, he will now supervise two similar cases in India.”The Shakeels, Muslims from eastern Bihar state, are to make the difficult decision on the operation during Ramadan, the Muslim month of fasting.The family are poor and a Gulf prince has agreed to pay all treatment costs after reading about the twins’ plight.Veena and Vani, who have no benefactor, are in the care of the Government General Hospital in Guntur.“They live in the hospital because they have been abandoned,” Sibal told AFP, adding that Apollo would have to raise contributions from the public to treat the girls.

But, said Sibal, before any tests can be carried out to identify whether they are good candidates for surgery, the girls’ parents must be traced. “You need the consent of the parent or identify who the legal guardian is,” he said. Veena and Vani do have a caring doctor, who, the Times says, turned down a request to operate on the Shakeel twins because he already had his hands full. The newspaper also said that Yarlagadda Nayudamma, former director of the Guntur hospital and a professor of pediatric surgery, has successfully operated on three sets of conjoined twins. Carson, was the lead neurosurgeon of a 70-member team that successfully separated seven-month-old German twin boys in 1987. In 1997, he and a team of 50 doctors separated 11-month-old Zambian boys, both of whom survived. He was also involved in at least three other attempts to separate conjoined twins, including the unsuccessful 2003 operation on the 29-year-old Bijani twins from Iran.

http://www.alseyassah.com/arabtimes/world/Viewdet.asp?ID=6062&cat=a

On the Net:

The 7th International Congress on AIDS in Asia and the Pacific: http://www.icaap7.jp/

http://news.yahoo.com/s/ap/20050604/ap_on_re_as/japan_aids_worries

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Schools Opening Up to Alternative Medicine
By JOANN LOVIGLIO, Associated Press Writer
2 hours, 33 minutes ago
PHILADELPHIA - Once largely dismissed as a leftover fad from the Age of Aquarius, acupuncture, herbal remedies and other forms of alternative medicine are finding their way into curriculums at traditional medical schools — most recently the University of Pennsylvania.

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"In the days before we could image the brain it was very hard to know about how these things worked, why placebos work in some people," he said. "We can image the brain now and see why they feel better. Nothing is off limits."

http://news.yahoo.com/s/ap/20050605/ap_on_he_me/apn_alternative_medicine

Cases of HIV/AIDS in the U.S. - FAQ at CDC
Blacks hardest hit by HIV in U.S. - report Reuters
HIV/AIDS Resource Center Y! Health Slideshow: HIV/AIDS Discuss

http://news.yahoo.com/fc/Health/AIDS___HIV

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Alzheimer’s disease
Trung Minh Thai, M.D.
Introduction

Alzheimer’s disease was first described by Alois Alzheimer, a German physician in 1907.
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Definition of Alzheimer dementia (AD)

The hallmark of Alzheimer dementia (AD)


AD results in structural as well as functional change in the brain

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Differential diagnoses

Prevalence and Impact of AD.

AD is the most common cause of dementia in people of 65 year and older.

Because the majorities of patients live at home and are cared for by family members, AD not only affects patients’ quality of life but also causes tremendous burden to patients family members.

Conclusion

AD is a degenerative brain disease that afflicts elderly patients. Although AD is not preventable, its onset can be delayed by minimizing risk factors. Cardiovascular diseases and Diabetes are considered among the main risk factors. Stress is another risk factor that is easily overlooked. Long term stress can increase glucocorticoids and decrease Brain derived nerve growth factors (BDNF). These changes can cause neuronal toxicity and result in neuronal damage or death.

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Scientists make blood from human stem cells

By Sonali Paul
Thu Jun 16, 5:25 AM ET

MELBOURNE (Reuters) - Australian scientists say they have found a way to make blood cells in volume out of human master cells, which could eventually lead to production of safe blood cells for transfusions and organ transplants

Synthetically produced red blood cells would, in theory, overcome the concerns about dangerous infections that can be transmitted from blood donors to patients worldwide.

But researchers said it would probably take years for scientists to get to the stage where blood cells could be made in large enough quantities for transfusions.

"What would be nice is if it opens the possibility for the future of making large quantities of blood cells in a controlled environment which could be used to treat patients," said Andrew Elefanty, who led the research at Monash University in Melbourne.

Writing in the U.S. journal Blood, the researchers said they were able to turn human embryonic stem cells into red and white blood cells using a system that makes more blood cells more rapidly and more safely, with fewer animal ingredients, than others have done.

"The other thing we think is important is that the way we've made the cells develop into blood is something which could be applied to other types of cells as well," Elefanty told Reuters.

The team's system was able to stimulate the stem cells specifically into becoming red or white cells.

Elefanty said the research showed that the path that human embryonic stem cells take in becoming blood cells was similar to experiments done in other animals, like mice.

While other researchers have used serum from cows as the medium for growing cells, the Monash team used a cocktail of salt and electrolyte solutions with amino acids and fats.

The system was not completely free of animal proteins, as the albumin was purified from cows. The team plans to use synthetic albumin eventually when it becomes available

http://news.yahoo.com/s/nm/20050616/sc_nm/health_australia_stemcells_dc_2

Hay fever not linked to kids' immunizations

Fri Jun 17, 3:58 PM ET

NEW YORK (Reuters Health) - Routine childhood immunizations do not increase the likelihood that kids will develop hay fever, according to a UK study.

"Suggestions that immunization influences allergic disease risk ... are of concern for vaccination policy," Dr. D. G. Cook, of St. George's Hospital Medical School, London, and colleagues write in the Archives of Disease in Childhood.

The researchers examined whether vaccinations in infancy influence the risk of hay fever using data from two large primary care databases in the UK -- the General Practice Research Database and the Doctors' Independent Network.

A total of about 3500 hay fever cases were matched with similar but unaffected individuals.

The relatively few children that had not been vaccinated for diphtheria, tetanus and pertussis (DTP) had virtually the same hay fever risk as the large percentage that completed DTP vaccinations by their fifth month.

As for measles, mumps and rubella (MMR) immunization, unvaccinated children had slightly lower chances of having hay fever than those vaccinated in month 14, although the difference was not statistically significant.

The investigators found that with both DPT and MMR vaccination, children that got their shots late had about a 40 percent reduced risk of hay fever. The team suggests that this "may be explained by a third factor causing both postponement and reduced risk, such as intercurrent febrile illness."

Cook and colleagues also looked at anti-TB immunization with BCG vaccine, which is thought to protect against becoming allergic. However, that's not what they found. "Immunization with BCG by age 2 was associated with an increased risk of hay fever," they report.

Overall, the researchers conclude that their results should reassure parents and doctors, and they stress that no opportunity to immunize should be missed.

SOURCE: Archives of Disease in Childhood, June 2005.

http://news.yahoo.com/s/nm/20050617/hl_nm/hayfever_immunizations_dc

Bronchitis Sufferers Can Skip Antibiotics

By DEANNA BELLANDI, Associated Press Writer
2 hours, 47 minutes ago

CHICAGO - A study found that bronchitis sufferers who are otherwise healthy do not get better any faster by taking antibiotics. "Antibiotics for the vast majority of people don't seem to make much difference," said Dr. Paul Little, author of the five-year study of patients in England. Moreover, many bronchitis cases are caused by viruses, which antibiotics do not fight.

Bronchitis is a highly common ailment. The findings suggest one major area where doctors can economize on the use of antibiotics. Overuse of antibiotics is believed to be contributing to the rise of dangerous drug-resistant strains of bacteria.

Little said that otherwise healthy patients can skip the drugs to treat the chest infections, even though they will feel crummy for a couple of weeks. But patients with conditions such as chronic lung and heart disease that can cause bronchitis to develop into pneumonia should see their doctors, he said.

In the study, coughing lasted an average of 11 days after patients saw their doctors, whether they got antibiotics or not. Other symptoms, such as phlegm and shortness of breath, were reduced by less than a day for people treated with amoxicillin or erythromycin.

"They all got better in the same time," said Little, a professor of primary care research at the University of Southampton.

The study, based on 640 patients ages 3 and older, was published in Wednesday's Journal of the American Medical Association. The study excluded patients with conditions that could complicate their bronchitis, such as asthma or heart and lung disease.

One study participant who did not receive antibiotics developed pneumonia and was hospitalized. The patient was treated with antibiotics and recovered fully.

"The findings of this study will probably surprise many clinicians and most patients," Dr. Mark Ebell, an associate professor of family practice at Michigan State University and a family physician in Athens, Ga.

http://news.yahoo.com/s/ap/20050622/ap_on_he_me/antibiotics_bronchitis