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Teen diagnoses her own disease in science class
In her Advanced Placement high school science class, she was looking under the microscope at slides of her own intestinal tissue — slides her pathologist had said were completely normal — and spotted an area of inflamed tissue called a granuloma, a clear indication that she had Crohn’s disease.
“It’s weird I had to solve my own medical problem,” Terry told CNN affiliate KOMO in Seattle, Washington. “There were just no answers anywhere. … I was always sick.”
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Crohn’s disease is often misdiagnosed or diagnosed very late, says Dr. Corey Siegel, director of the Inflammatory Bowel Disease Center at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire. “Granulomas are oftentimes very hard to find and not always even present at all,” Siegel said. “I commend Jessica for her meticulous work.”
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Multiple antibiotic-resistant bacteria has emerged as one of the top public health issues worldwide in the last few decades as the overuse of antibiotics and other factors have caused bacteria to become resistant to common drugs. Chuanwu Xi’s group chose to study Acinetobacter because it is a growing cause of hospital-acquired infections and because of its ability to acquire antibiotic resistance.
Xi said the problem isn’t that treatment plants don’t do a good job of cleaning the water—it’s that they simply aren’t equipped to remove all antibiotics and other pharmaceuticals entering the treatment plants.
The treatment process is fertile ground for the creation of superbugs because it encourages bacteria to grow and break down the organic matter. However, the good bacteria grow and replicate along with the bad. In the confined space, bacteria share resistant genetic materials, and remaining antibiotics and other stressors may select multi-drug resistant bacteria.
While scientists learn more about so-called superbugs, patients can do their part by not insisting on antibiotics for ailments that antibiotics don’t treat, such as a common cold or the flu, Xi said. Also, instead of flushing unused drugs, they should be saved and disposed of at designated collection sites so they don’t enter the sewer system.
The next step, said Xi, is to see how far downstream the superbugs survive and try to understand the link between aquatic and human superbugs. This study did not look past 100 yards.
Xi’s colleagues include visiting scholar Yongli Zhang; Carl Marrs, associate professor of public health; and Carl Simon, professor of mathematics.
Xi and colleagues found that while the total number of bacteria left in the final discharge effluent declined dramatically after treatment, the remaining bacteria was significantly more likely to resist multiple antibiotics than bacteria in water samples upstream. Some strains resisted as many as seven of eight antibiotics tested. The bacteria in samples taken 100 yards downstream also were more likely to resist multiple drugs than bacteria upstream.
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Antigenic shift is the process by which at least two different strains of a virus, (or different viruses), especially influenza, combine to form a new subtype having a mixture of the surface antigens of the two original strains.
Pigs can be infected with human, avian and swine influenza viruses. Because pigs are susceptible to all three they can be a breeding ground for antigenic shift (as in the recent case of H1N1 Flu - Swine Flu) allowing viruses to mix and create a new virus.
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Surgeon-engineer advances high-tech healing
She also designed a procedure for using the robot for gastric-bypass surgery. Her paper on the procedure was published in 2006 in Obesity Surgery, a medical journal. “Someone who needs a gastric bypass has a thick abdominal wall,” Mohr explains. “It can take months for incisions to heal, so you want to do the operation through the smallest incision you can.”
The operation is also ergonomically challenging for the surgeon. “What you’re doing inside is very challenging, and you can’t stand terribly close because these patients are so large,” she says. “It seemed to me that this was something we should do with the robot.”
The surgeon uses controllers to drive the laparoscopic instruments held by the robot, and a screen to view the action. “You don’t cut what you can’t see,” she says.
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WHO Director-General, Dr Margaret Chan, announced today that she has “decided to raise the current level of influenza pandemic alert from phase 4 to phase 5.” And she further comments:
Let me remind you. New diseases are, by definition, poorly understood. Influenza viruses are notorious for their rapid mutation and unpredictable behaviour. WHO and health authorities in affected countries will not have all the answers immediately, but we will get them.
WHO will be tracking the pandemic at the epidemiological, clinical, and virological levels. All countries should immediately activate their pandemic preparedness plans. Countries should remain on high alert for unusual outbreaks of influenza-like illness and severe pneumonia.
At this stage, effective and essential measures include heightened surveillance, early detection and treatment of cases, and infection control in all health facilities.
I have reached out to companies manufacturing antiviral drugs to assess capacity and all options for ramping up production. I have also reached out to influenza vaccine manufacturers that can contribute to the production of a pandemic vaccine.
The biggest question, right now, is this: how severe will the pandemic be, especially now at the start?
It is possible that the full clinical spectrum of this disease goes from mild illness to severe disease. We need to continue to monitor the evolution of the situation to get the specific information and data we need to answer this question.
From past experience, we also know that influenza may cause mild disease in affluent countries, but more severe disease, with higher mortality, in developing countries.
No matter what the situation is, the international community should treat this as a window of opportunity to ramp up preparedness and response.
Above all, this is an opportunity for global solidarity as we look for responses and solutions that benefit all countries, all of humanity. After all, it really is all of humanity that is under threat during a pandemic.
As I have said, we do not have all the answers right now, but we will get them.
—- end of her remarks —-
The latest WHO Epidemic and Pandemic Alert and Response release puts the total number of confirmed cases at 148, in 9 countries, with 8 deaths. Mexico has many more suspected cases but just 26 confirmed cases. The CDC Swine Influenza site, puts the total number of confirmed cases in the USA at 91, in 10 states, with 1 death.
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World Health Organization on Swine influenza
The Committee nevertheless agreed that the current situation constitutes a public health emergency of international concern.
Based on this advice, the Director-General has determined that the current events constitute a public health emergency of international concern, under the Regulations.
Swine flu: a quick overview–and new New York and Kansas cases by Tara Smith
Third, is this really a new virus? So few influenza isolates are actually analyzed each year (in proportion to the number of people infected) that we aren’t sure yet whether this is something brand-new, or something that has been circulating at a low level for awhile, but just hadn’t been picked up. After all, H1N1 is a common serotype, so additional molecular testing is needed to determine that it’s “swine flu” versus “human” H1N1.
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this is a fast-developing story, and it will take much more investigation and field work to determine the true extent of the virus’s spread in the population; to figure out… how efficiently it’s transmitted…
This is very early in the scientific inquiry process looking into what exactly is going on. It is too early to tell how serious a threat this is. The reaction of WHO, CDC though shows they are taking the threat seriously. By far the biggest danger in such situations, is reacting too slowly to serious and contagious threats. If you wait to react until proof exists that the situation is very serious the situation can be almost impossible to control. So you need to react quickly to shut down the spread of the threat, hopefully before it has spread too far.
Related: CDC site on Human Swine Influenza Investigation - Interview with Dr. Tara Smith - Reducing the Impact of a Flu Pandemic - H5N1 Influenza Evolution and Spread
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In a, chlorotoxin molecules, colored blue and green, attach themselves to a central nanoparticle. In b, each nanoprobe offers many chlorotoxin molecules that can simultaneously latch on to many MMP-2s, depicted here in yellow, which are thought to help tumor cells travel through the body. In c, over time nanoprobes draw more and more of the MMP-2 surface proteins into the cell, slowing the tumor’s spread. Image from the University of Washington.University of Washington researchers found they could cut the spread of cancerous cells by 98 percent, compared to 45 percent for the scorpion venom alone, by combining nanoparticles with a scorpion venom compound already being investigated for treating brain cancer.
For more than a decade scientists have looked at using chlorotoxin, a small peptide isolated from scorpion venom, to target and treat cancer cells. Chlorotoxin binds to a surface protein overexpressed by many types of tumors, including brain cancer. Previous research by Miqin Zhang’s group combined chlorotoxin with nanometer-scale particles of iron oxide, which fluoresce at that size, for both magnetic resonance and optical imaging.
Chlorotoxin also disrupts the spread of invasive tumors — specifically, it slows cell invasion, the ability of the cancerous cell to penetrate the protective matrix surrounding the cell and travel to a different area of the body to start a new cancer. The MMP-2 on the cell’s surface, which is the binding site for chlorotoxin, is hyperactive in highly invasive tumors such as brain cancer. Researchers believe MMP-2 helps the cancerous cell break through the protective matrix to invade new regions of the body. But when chlorotoxin binds to MMP-2, both get drawn into the cancerous cell.
Research showed that the cells containing nanoparticles plus chlorotoxin were unable to elongate, whereas cells containing only nanoparticles or only chlorotoxin could stretch out. This suggests that the nanoparticle-plus-chlorotoxin disabled the machinery on the cell’s surface that allows cells to change shape, yet another step required for a tumor cell to slip through the body.
So far most cancer research has combined nanoparticles either with chemotherapy that kills cancer cells, or therapy seeking to disrupt the genetic activity of a cancerous cell. This is the first time that nanoparticles have been combined with a therapy that physically stops cancer’s spread.
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USA Center for Disease Control: Application of Lower Sodium Intake Recommendations for Adults, 1999-2006 study
In 2005-2006, an estimated 29% of U.S. adults had hypertension (i.e., high blood pressure), and another 28% had prehypertension. The estimated average intake of sodium for those in the United States over 2 years old was 3,436 mg/day while the U.S. Department of Health and Human Services and U.S. Department of Agriculture recommended adults should consume no more than 2,300 mg/day of sodium (equal to approximately 1 tsp of salt), but those in specific groups (i.e., all persons with hypertension, all middle-aged and older adults, and all blacks) should consume no more than 1,500 mg/day of sodium (69% of U.S. adults should consume no more than !,500 mg/day). There is substantial evidence linking greater sodium intake to higher blood pressure.
Sodium reduction is recommended for persons with hypertension and as a first line of intervention for persons with prehypertension. Public health actions to reduce sodium intake likely will include reducing the sodium content of processed foods; encouraging consumption of more low-sodium foods, such as fruits and vegetables; and providing more relevant information about sodium in food labeling.
The current daily percentage value for sodium in the nutrition facts panel of packaged foods is based on a previous federal guideline of 2,400 mg/day and is likely to mislead the majority of consumers, for whom the 1,500 mg/day limit is applicable.
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Photo of John Cooke at the Cardiac Catheterisation Labs at St. Thomas’ hospital in LondonI manage several blogs on several topics that are related. Often blog posts stay firmly in the domain of one blog of the other. Occasionally the topic blurs the lines between the various blogs (which I like). This post ties directly to my Curious Cat Management Improvement Blog. The management principles I believe in are very similar to engineering principles (no surprise given this blog). And actual observation in situ is important - to understand fully the situation and what would be helpful. Management relying on reports instead of seeing things in action results in many poor decisions. And engineers doing so also results in poor decisions.
Getting to Gemba - a day in the Cardiac Cath Lab by John Cooke
The whole experience reminded me that in terms of innovation getting to gemba is critical. When was the last time you saw your products in use up-close and personal?
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image created by Dr. Jean-Yves Sgro, Institute for Molecular Virology, University of Wisconsin-Madison, from published X-ray data. larger imageSequences capture the code of the common cold
“We’ve had bits and pieces of these things for a long time,” says Ann Palmenberg, of UW-Madison’s Institute for Molecular Virology and the lead author of the new study. “Now, we have the full genome sequences and we can put them into evolutionary perspective.”
As its name implies, the common cold is an inescapable, highly contagious pathogen. Humans are constantly exposed to cold viruses, and each year adults may endure two to four infections, while schoolchildren can catch as many as 10 colds.
“We know a lot about the common cold virus,” Palmenberg explains, “but we didn’t know how their genomes encoded all that information. Now we do, and all kinds of new things are falling out.”
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The newly sequenced viruses also show, says Palmenberg, why it is unlikely we will ever have an effective, all-purpose cold vaccine: The existing reservoir of viruses worldwide is huge and, according to the new study, they have a tendency to swap genetic sequences when cells are infected by more than one virus, a phenomenon that can lead to new virus strains and clinical manifestations.
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The ability of different cold virus strains to swap genes and make entirely new strains was thought to be impossible, notes Claire M. Fraser-Liggett, a co-author of the new study and director of the Institute for Genome Sciences and professor of medicine and microbiology at the University of Maryland School of Medicine. “There is the possibility that this could lead to the emergence of a new rhinovirus strain with fairly dramatic properties,” says Fraser-Liggett.
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Ben Goldacre, in his bad science blog, again takes on journalist’s articles of health research in: Venal, misleading, pathetic, dangerous, stupid, and busted
For complex risk decisions like screening, it has been shown in three separate studies that patients, doctors, and NHS purchasing panels make more rational decisions about treatments and screening programmes when they are given the figures as real numbers, as I did above, instead of percentages. I’m not saying that PSA screening is either good or bad: I am saying that people deserve the figures in the clearest form possible so they can make their own mind up.
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So newspapers ignore one half of the evidence, and they fail to explain the other half properly.
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They can also link directly and transparently to scientific papers, which mainstream media still refuses to do. Journalists insist that we need professionals to mediate and explain science. From today’s story, their self belief seems truly laughable.
He also says some journalists got it right including the Washington Post in, Prostate Cancer Screening May Not Reduce Deaths:
I think it is true that most people need help having science mediated to some extent. But he is also right that those doing so need to do better. And also everyone needs to learn about science to understand the choices they personally and politically (for policy issues) need to make decisions on. Being scientifically illiterate is dangerous.
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High-energy X-ray diffraction was used to pinpoint some 5 million atoms in the protective protein coat of the PsV-F virus. The coat’s symmetrical features are shared by hundreds of viruses. The red and yellow sections illustrate how building blocks of four proteins come together to form the spherical shell.The image reveals the structure of a type of protein coat shared by hundreds of known viruses containing double-stranded RNA genomes. The image was painstakingly created from hundreds of high-energy X-ray diffraction images and paints the clearest picture yet of the viruses’ genome-encasing shell called a “capsid.”
Viruses can reproduce themselves only by invading a host cell and highjacking its biochemical machinery. But when they invade, viruses need to seal off their genetic payload to prevent it from being destroyed by the cell’s protective mechanisms. Though there are more than 5,000 known viruses, including whole families that are marked by wide variations in genetic payload and other characteristics, most of them use either a helical or a spherical capsid.
“Spherical viruses like this have symmetry like a soccer ball or geodesic dome,” Pan said. “The whole capsid contains exactly 120 copies of a single protein.” Previous studies had shown that spherical capsids contain dozens of copies of the capsid protein, or CP, in an interlocking arrangement. The new research identified the sphere’s basic building block, a four-piece arrangement of CP molecules called a tetramer, which could also be building blocks for other viruses’ protein coats.
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Researchers at UT Southwestern Medical Center identified a receptor, known as QseE, which resides in a diarrhea-causing strain of E coli. The receptor senses stress cues from the bacterium’s host and helps the pathogen make the host ill. A receptor is a molecule on the surface of a cell that docks with other molecules, often signaling the cell to carry out a specific function.
Dr. Vanessa Sperandio, associate professor of microbiology at UT Southwestern and the study’’ senior author, said QseE is an important player in disease development because the stress cues it senses from a host, chiefly epinephrine and phosphate, are generally associated with blood poisoning, or sepsis.
“Patients with high levels of phosphate in the intestine have a much higher probability of developing sepsis due to systemic infection by intestinal bacteria,” Dr. Sperandio said. “If we can find out how bacteria sense these cues, then we can try to interfere in the process and prevent infection.”
Millions of potentially harmful bacteria exist in the human body, awaiting a signal from their host that it’s time to release their toxins. Without those signals, the bacteria pass through the digestive tract without infecting cells. What hasn’t been identified is how to prevent the release of those toxins.
“There’s obviously a lot of chemical signaling between host and bacteria going on, and we have very little information about which bacteria receptors recognize the host and vice versa,” Dr. Sperandio said. “We’re scratching at the tip of the iceberg on our knowledge of this.”
“When people are stressed they have more epinephrine and norepinephrine being released. Both of these human hormones activate the receptors QseC and QseE, which in turn trigger virulence. Hence, if you are stressed, you activate bacterial virulence.” Dr. Sperandio said the findings also suggest that there may be more going on at the genetic level in stress-induced illness than previously thought.
“The problem may not only be that the stress signals are weakening your immune system, but that you’re also priming some pathogens at the same time,” she said. “Then it’s a double-edged sword. You have a weakened immune system and pathogens exploiting it.”
Previous research by Dr. Sperandio found that phentolamine, an alpha blocker drug used to treat hypertension, and a new drug called LED209 prevent QseC from expressing its virulence genes in cells. Next she will test whether phentolamine has the same effect on QseE.
Full press release: Researchers probe mechanisms of infection
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Ozone Pollution Taking Toll on American Lives by Amanda Gardner
The greatest risk may for those living be in hot, dry cities such as Los Angeles, which has one of the highest concentrations of ozone. Residents of Los Angeles may face a 25 percent to 30 percent higher annual risk of dying from a respiratory ailment versus people in low-ozone areas such as the Great Plains, the researchers said.
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An estimated 240,000 people in the United States and 7.7 million people worldwide die of respiratory disease each year, according to data from the World Health Organization. Efforts to reduce ground-level ozone have stalled in recent years, Jarrett said, and now one in three Americans lives in an area that exceeds the national standard for ozone levels.
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Ozone is also a powerful greenhouse gas, Jerrett said, so measures to improve health might have the added benefit of slowing climate change.
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Scientists Learning to Target Bacteria Where They Live
The answer, say researchers, is to find substances that will break up biofilms.
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Melander said “a throwaway sentence in an obscure journal” — the Bulletin of the Chemical Society of Japan — gave them another clue. They isolated a compound from the sponge that disperses biofilms and figured out how to synthesize it quickly and cheaply.
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But dispersing biofilms without understanding all the ramifications could be a “double-edged sword,” Romeo warned, because some bacteria in a biofilm could wreak worse havoc once they disperse.
“Simply inducing biofilm dispersion without understanding exactly how it will impact the bacterium and host could be very dangerous, as it might lead to spread of a more damaging acute infection,” he said.
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A Randomized Trial Comparing Low-Fat and Low-Carbohydrate Diets Matched for Energy and Protein
Essentially the study showed that the calories had an impact on weight loss but the makeup of those calories did not. Don’t forget this is just one study. Listen to interview with the Author, Frank Sacks, on Science Friday on NPR.
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