Thursday 30th April 2015- BBC News: ‘First natural birth’ for diabetic woman with artificial pancreas

‘Catriona Finlayson-Wilkins, 41, of Knapton, Norfolk, gave birth to son Euan on Tuesday at the Norfolk and Norfolk University Hospital.

She is also the first woman to give birth after using the device outside the main research site in Cambridge.

Ms Finlayson-Wilkins said she was “thrilled” by her son’s safe arrival.

The new mother-of-two has Type 1 diabetes and wore the piece of kit throughout her pregnancy to produce insulin and prevent symptoms of the disease.

Three other mothers have previously given birth in Cambridge after using the device but by caesarean section.’

‘An artificial pancreas device system (APDS) is a small portable piece of equipment designed to carry out the function of a healthy pancreas.

It helps to control blood glucose levels using digital communication technology to automate insulin delivery.’

See:

‘First natural birth’ for diabetic woman with artificial pancreas

Thursday 30th April 2015- The Scientist: Eye Stem Cell Therapy Moves Ahead

‘Scientists in Korea have injected human embryonic stem cell (hESC)-derived retinal support cells into the eyes of four men with macular degeneration, according to a study published today (April 30) in Stem Cell Reports. Three of the men experienced vision improvements in their treated eyes in the year following the procedure, while the fourth man’s vision remained largely the same. The trial adds to growing evidence that injecting hESC-derived cells is feasible, feeding hopes for their future therapeutic use.’

‘This latest study follows on two papers published in The Lancet in 2012 and 2014, which similarly demonstrated that hESC-derived cells could be safely injected into the space behind the retina in macular degeneration patients. These studies, sponsored by the Massachusetts-based company Advanced Cell Technology (now Ocata Therapeutics), were the first published accounts describing the application of hESC-based therapies in humans.

Korean company CHA Biotech carried out the new trial. Ocata provided the hESCs and some methodological instruction. “Together with the results here in the US, I think this bodes well for the future of stem cell therapies,” said study coauthor Robert Lanza, chief scientific officer at Ocata.

Jeanne Loring, a stem cell researcher at the Scripps Research Institute in La Jolla, California, agreed that the apparent safety of the therapy in the subjects tested is encouraging. However, she added, it would be difficult to draw firm conclusions about efficacy based on such a small study. “I think it’s still anecdotal that some people seem to improve,” said Loring.’

See:

Eye Stem Cell Therapy Moves Ahead

Thursday 30th April 2015- World Health Organisation: WHO, health partners striving to treat quake survivors in Nepal’s remote regions

‘WHO has stepped up efforts to deliver critical medical relief to populations outside of the Kathmandu valley affected by Saturday’s earthquake, with a major focus on reaching injured people and preventing disease outbreaks.

Coordinating health sector partners in support of Nepal’s government, WHO is striving to reach remote areas beyond the capital, Kathmandu, where road access has been hampered by damage caused by the 25 April earthquake.’

‘To date, Sindhupalchowk has reported the highest fatalities of any region in Nepal. Authorities say that at least 1400 people had died there, and warning that the number could rise to 3000.

Many people in the district have been displaced, while others require immediate medical attention, which so far has been difficult to provide. Landslides block the district’s transport arteries and the terrain is often inaccessible.’

See:

WHO, health partners striving to treat quake survivors in Nepal’s remote regions

Thursday 30th April 2015- BBC News: US ‘will not fund research for modifying embryo DNA’

‘Modifying the DNA of embryos is a “line that should not be crossed”, a leading figure in US research says.

Dr Francis Collins, National Institutes of Health director, was responding to reports that the first embryos had been modified in China.

He argued there were “serious and unquantifiable safety issues”, big ethical questions and no compelling medical reason to do it.

He said the NIH would not fund such research in the US.

The advent of “Crispr technology” – which is a more precise way of editing DNA than anything that has come before – has spurred huge progress in genetics.

But there had been growing concern these tremendous advances were making the modification of human embryos more likely.’

‘There have been repeated calls for a worldwide freeze on such research while society as a whole decides what should be allowed.

However, the US National Institutes of Health has made its position clear – that no such research should take place.

Dr Collins, who was also a key player in the Human Genome Project, released a statement saying: “The concept of altering the human germline in embryos for clinical purposes has been debated over many years from many different perspectives, and has been viewed almost universally as a line that should not be crossed.’

See:

US ‘will not fund research for modifying embryo DNA’

Wednesday 29th April 2015- World Health Organisation: WHO report finds systems to combat antibiotic resistance lacking

‘A quarter of countries that responded to a WHO survey have national plans to preserve antimicrobial medicines like antibiotics, but many more countries must also step up. A new report, “Worldwide country situation analysis: Response to antimicrobial resistance”, which outlines the survey findings, reveals that while much activity is underway and many governments are committed to addressing the problem, there are major gaps in actions needed across all 6 WHO regions to prevent the misuse of antibiotics and reduce spread of antimicrobial resistance.’

‘Issued a year after WHO’s first report on the extent of antimicrobial resistance globally, which warned of a ‘post-antibiotic era’, this survey—which was completed by 133 countries in 2013 and 2014—is the first to capture governments’ own assessments of their response to resistance to antimicrobial medicines used to treat conditions such as bloodstream infections, pneumonia, tuberculosis (TB), malaria and HIV. It summarizes current practices and structures aimed to address the issue, and shows there are significant areas for improvement.’

‘Key findings of the report include:

• Few countries (34 out of 133 participating in the survey) have a comprehensive national plan to fight resistance to antibiotics and other antimicrobial medicines.
• Monitoring is key for controlling antibiotic resistance, but it is infrequent. In many countries, poor laboratory capacity, infrastructure and data management are preventing effective surveillance, which can reveal patterns of resistance and identify trends and outbreaks.
• Sales of antibiotics and other antimicrobial medicines without prescription remain widespread, with many countries lacking standard treatment guidelines, increasing the potential for overuse of antimicrobial medicines by the public and medical professionals.
• Public awareness of the issue is low in all regions, with many people still believing that antibiotics are effective against viral infections.
• Lack of programmes to prevent and control hospital-acquired infections remains a major problem.’

Related Articles:

WHO report finds systems to combat antibiotic resistance lacking

Most countries not protecting antibiotics, says WHO- BBC News

Wednesday 29th April 2015- BBC News: Rubella (German measles) eradicated from Americas

‘North and South America have become the first regions of the world to eradicate rubella, or German measles, after no home-grown cases in five years.

The virus – spread by sneezes or coughs – can lead to serious birth defects if contracted by pregnant women.

Up to 20,000 children were born with rubella in the Americas every year until mass vaccinations started.

But the last endemic cases registered in the region were in Argentina and Brazil in 2009.

The fact no new cases have been declared in five consecutive years, apart from those imported into the region, allowed global health chiefs to declare the Americas free of the virus.’

See:

Rubella (German measles) eradicated from Americas

Tuesday 28th April 2015- The British Medical Journal: WHO calls for $5m for earthquake relief

‘The World Health Organization has called for $5m (£3.3m; €4.6m) to help it respond to the grave humanitarian situation in Nepal after the country was hit by an earthquake measuring 7.8 on the Richter scale.

Both the earthquake, which struck on 25 April, and around 60 aftershocks have caused heavy damage as well as thousands of deaths and injuries. Unicef said on 27 April that nearly 5000 people had died and 50 000 had been injured, although these figures are expected to rise. Thousands more have been left homeless and are sheltering in tents.’

See:

WHO calls for $5m for earthquake relief

Monday 27th April 2015- The Scientist: Combatting Viruses with RNA-Targeted CRISPR

‘Scientists reengineer a Cas9 enzyme that naturally targets bacterial RNA to stymie hepatitis C inside human cells.’

‘The list of potential uses for the CRISPR/Cas system grows longer by the day. Now fighting viruses may soon be added to that list, according to a study published today (April 27) in PNAS. Microbiologist David Weiss and immunologist Arash Grakoui of Emory University in Atlanta and their colleagues used a version of the Cas9 enzyme from the bacteriaFrancisella novicida to bind hepatitis C virus (HCV) RNA and prevent the pathogen from replicating inside human cells.’

See:

Combatting Viruses with RNA-Targeted CRISPR

Friday 24th April 2015- The Telegraph: Parents lose court battle over fitting a heart monitoring device in their seven-year-old daughter

‘A couple who did not want specialists to implant a special heart monitoring device into their seven-year-old daughter have lost a family court fight.

Doctors say the youngster has a rare heart problem, has suffered one cardiac arrest and might die if she suffers another.

They say the best way to guard against another cardiac arrest is to fit an implantable cardioverter defibrillator (ICD), which monitors heart rhythm, can deliver a shock and can act as a pacemaker.

But the girls’ parents objected to the surgery after being told there was a risk of infection and a risk of the device administering an unnecessary shock.

They said she should be fitted with a type of monitoring device she could wear like a ”vest”, and a judge was asked to make a decision.

Mr Justice Bodey ruled that fitting the ICD would be in the girl’s best interests following a hearing in the Family Division of the High Court in London.’

See:

Parents lose court battle over fitting a heart monitoring device in their seven-year-old daughter

Friday 24th April 2015- The British Medical Journal: Risk of gastrointestinal bleeding associated with oral anticoagulants: population based retrospective cohort study

‘Objectives To determine the real world safety of dabigatran or rivaroxaban compared with warfarin in terms of gastrointestinal bleeding.’

‘Setting Large administrative database of commercially insured people in United States from 1 October 2010 through 31 March 2012.

Participants Enrollees with a prescription of warfarin, dabigatran, or rivaroxaban between 1 October 2010 and 31 March 2012, who were aged 18 years or older, had continuous enrollment and no oral anticoagulant use during the six months before the entry date, with known age and sex, and with no gastrointestinal bleeding for at least six months before the cohort entry date. The final study sample of 46 163 patients included 4907 using dabigatran, 1649 using rivaroxaban, and 39 607 using warfarin.

Main outcome measure Time to gastrointestinal bleeding. Hazard ratios were derived from Cox proportional hazard models with propensity score weighting and robust estimates of errors.

Results Dabigatran users tended to be older (dabigatran v rivaroxaban v warfarin: 62.0 v 57.6 v 57.4 years) and more likely to be male (69% v 49% v 53%). The rate of gastrointestinal bleeding was highest among dabigatran users and lowest among rivaroxaban users (dabigatran v rivaroxaban v warfarin: 9.01 v 3.41 v 7.02 cases per 100 person years). After adjustment for potentially confounding covariates, there was no evidence of a statistically significant difference in the risk of gastrointestinal bleeding between dabigatran and warfarin users (adjusted hazard ratio 1.21, 95% confidence interval 0.96 to 1.53) or between rivaroxaban and warfarin users (0.98, 0.36 to 2.69).

Conclusions Although rates of gastrointestinal bleeding seem to be similar in this commercially insured sample of adults in the United States, we cannot rule out as much as a 50% increase in the risk of gastrointestinal bleeding with dabigatran compared with warfarin or a more than twofold higher risk of bleeding with rivaroxaban compared with warfarin.’

See:

Research Study: Risk of gastrointestinal bleeding associated with oral anticoagulants: population based retrospective cohort study