Monday, 3 September 2012

scientists really do not read their own words


Gorillas and chimps are threatened by human disease

Eastern gorilla (Arup Shah / NPL)

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In a bid to save wild apes from extinction, people may be unwittingly infecting them with potentially deadly diseases, new research shows.
Humans and great apes are closely related, creating the potential for diseases to jump between them.
Isolated incidents have been documented of apes and monkeys contracting measles, pneumonia, and influenza from people, as well as a range of other bacteria, viruses and parasites.
But the problem may be greater than even that, as highlighted by five recently published academic studies.

Your close cousins

Chimpanzees
The close contact between animals and humans in research centres and sanctuaries is facilitating the spread of pathogens to apes, say scientists.
A newly published study by researchers in Japan examined blood serum from 14 captive chimpanzees in Japanese primate research institutes.
Takanori Kooriyama of the Rakuno Gakuen University in Ebetsu, and colleagues across Japan, tested for antibodies against 62 human pathogens.
The chimps had antibodies against 29 of these pathogens, showing they had been exposed to them.
"Captive chimpanzees are highly susceptible to human pathogens," the researchers write in the journal Primates.
Bad bugs
Earlier this month, Frieder Schaumberg of the Institute of Medical Microbiology in Munster, Germany, and colleagues in Germany, the US and Uganda, published a revealing study in the American Journal of Primatology.
They found a high prevalence of drug-resistant Staphylococcus aureusbacteria in sanctuary chimpanzees in Zambia and Uganda.
Chimp and humanHelping hand or health risk?
These bacteria were likely passed to the apes by the veterinarians and staff caring for them.
The bugs are difficult to eradicate and can cause skin and tissue infections as well as severe bouts of pneumonia and septicaemia.
The study shows specifically that human pathogens can be passed to apes that are destined for release in the wild.
Researchers say that plans to reintroduce apes into the wild need to be re-evaluated to prevent drug-resistant diseases being spread through populations of rare animals.
Knowing the risks
Steve Unwin of the Animal Health Centre at Chester Zoo, UK and colleagues in the UK and US, agree that the development is "worrying".
But in the same issue of the journal, they argue that it is too soon to consider stopping reintroductions.

Past ills

  • Humans, possibly ecotourists, are thought to have passed the skin disease scabies and intestinal worms to gorillas living in Biwindi National Park, Uganda
  • Human metapneumovirus is suspected to have killed mountain gorillas in Rwanda, and been responsible for chimpanzee die offs in Tai National Park in Cote D'Ivoire.
The problem has been known for a while, they say, and the International Union for the Conservation of Nature (IUCN) has developed a set of guidelines governing the release of animals and rare species back into the wild.
These guidelines recommend screening animals for health issues prior to their release and potentially placing them in quarantine.
By testing for human-borne diseases, and preventing the release of infected animals, the problem may be averted, they say.
Two researchers, Charles Nunn of Harvard University, Massachusetts, US and Brian Hare of Duke University, North Carolina, US, who are experts in the evolutionary biology of humans and other apes, also comment in the same journal.
They recommend a number of areas for future research.
For example, to better understand the risks, we need to know more about how antibiotic-strains of bacteria spread between individual apes, and whether they actually cause any greater sickness or death in these animals.
It may be that other pathogens we are unaware of can spread between humans and apes too. And young animals are more prone to infection, as they spend more time in physical contact with sanctuary workers.
Scratched and bitten
Solving the problem is difficult, in part because passing diseases to primates is a practical as well as an ethical issue.
As Prof Nunn and Prof Hare point out in their paper, the release of apes back into the wild remains an art form.

Gorilla marvels

Gorilla
Sanctuary managers face a range of political, time and financial pressures that limit their ability to take in new apes, care for them, and then release them.
Between 2000 and 2006, for example, the chimp population living at Pan African Sanctuary Alliance sanctuaries grew 15% a year, driven by the adoption of an average of 56 new apes each year - animals that had been orphaned by the bushmeat trade.
Reintroducing these animals is important, argue Unwin and colleagues.
Not only does it help rehabilitate the lives of individual apes, and boost numbers of rare species in the wild, but the process can help educate local people about the importance of conservation.
Diseases can spread of course from primates to people: the group of HIV viruses that cause AIDS has jumped from monkeys and chimpanzees into people, seeding a global human health crisis. Ebola meanwhile is harboured by gorillas.
A study published late last year by George Engel and Lisa-Jones Engel of the University of Washington, Seattle, US, in the American Journal of Primatology, presented the results of a survey of 116 primatologists who had worked closely with non-human primate species.
Of those surveyed, almost 60% said they had been scratched by a primate and 40% had been bitten, highlighting the risk of disease transmission.
But our ability to pass novel diseases back into ape and monkey species is less well known.

Monkey malaise

  • A study presented at the 35th Meeting of the American Society of Primatologists in Sacremento, California, US in June, showed that macaques had antibodies to both human and avian influenza viruses in areas where high densities of people live.
  • That reveals the macaques had been exposed to the viruses and may be susceptible to them.
  • Drs Engle and Engle sampled blood serum from more than 200 macaques at sites in Singapore, Bangladesh, Gibraltar, Cambodia and Indonesia.
Wild apes are also exposed to human pathogens through a number of different routes, including when apes raid crops, when tourists encounter apes in their natural habitat and when workers go into forests to exploit resources, such as mining, logging and the hunting of bushmeat.
At the heart of the issue is a painful dilemma. Contact between humans and apes often occurs because conservationists and researchers have to get close to the apes to save them.
Scientists themselves can pass diseases to the apes they study.
In recent years, primatologists have debated the extent to which they might be threatening the wild apes they research, and what to do about it.
Many research groups now wear face masks when close to their subjects, to avoid transmitting airborne diseases.
Disinfecting boots before heading into the forest, and observing apes from predetermined safe distances, are other safeguards, ones that many feel ecotourists should also follow.
For many primatologists, it seems, they are damned if they do and damned if they don't.
Sir David Attenborough meets a gorilla family
Populations of great apes; gorilla, chimp and orang-utan species, and the small apes, or gibbons, are dwindling around the world, and everything possible must be done to save them, they say.
Researchers must study the animals in the wild to understand them, and find better ways to protect them.
The benefits of such research far outweighs the costs, many experts argue.
As well as providing valuable information about the size and behaviour of great ape populations, the presence of researchers can deter poachers, encourage politicians to take an interest in primate conservation and directly save or protect the lives of many rare apes.
Sanctuaries take in apes as a last resort, and their reintroduction is considered to be an important conservation tool.
However, as the latest research shows, the difficult part is finding ways to save these closest relatives of ours, without unwittingly harming them in the process.

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Sunday, 2 September 2012

Human rights of old age


richimag said...
Human rights of old age
Next page


'Chemical cosh' early death risk

The drugs were designed to treat schizophrenia
Patients with dementia are dying early because they are being prescribed sedative drugs inappropriately in nursing homes, warn researchers.
A five-year investigation revealed the antipsychotic drugs were being used as a 'chemical cosh' to control patients, contrary to expert advice.
Patients prescribed these drugs were dying on average six months earlier, the Alzheimer's Research Trust found.
But GPs said the drugs were only used "as a last resort".
'Chemical cosh'
Guidelines say they can be given if the patient is severely agitated or violent.
But lead researcher Professor Clive Ballard says in the majority of cases the prescriptions are inappropriate and do more harm than good - doubling the risk of early death.
Estimates suggest that as many as 40% of nursing home residents with Alzheimer's disease - 150,000 people - are prescribed these drugs, known as neuroleptics

NHS announces new deadline to register claims For cases during the period 1st April 2004 – 31st March 2011 the deadline for individuals or their families and representatives to notify the relevant PCT will be 30th September 2012. For cases during the period 1st April 2011 – 31st March 2012 the deadline for individuals or their families and representatives to notify the relevant PCT will be 31st March 2013



NHS announces new deadline to register claimsFor cases during the period 1st April 2004 – 31st March 2011 the deadline for individuals or their families and representatives to notify the relevant PCT will be 30th September 2012.For cases during the period 1st April 2011 – 31st March 2012 the deadline for individuals or their families and representatives to notify the relevant PCT will be 31st March 2013

Thursday, 30 August 2012

Vitamin B3 'helps kill superbugs'????


Vitamin B3 'helps kill superbugs'


Drug-resistant MRSAAntibiotic resistance is increasing

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Vitamin B3 could be the new weapon in the fight against superbugs such as MRSA, researchers have suggested.
US experts found B3, also known as nicotinamide, boosts the ability of immune cells to kill Staphylococcus bacteria.
B3 increases the numbers and efficacy of neutrophils, white blood cells that can kill and eat harmful bugs.
The study, in the Journal of Clinical Investigation, could lead to a "major change in treatment", a UK expert said.
B3 was tested on Staphylococcal infections, such as the potentially fatal MRSA (Methicillin-resistant Staphylococcus aureus).
Such infections are found in hospitals and nursing homes, but are also on the rise in prisons, the military and among athletes.
'Turn on'
The scientists used extremely high doses of B3 - far higher than that obtained from dietary sources - in their tests, carried out both on animals and on human blood.

Start Quote

I cannot see why this couldn't be used straight away in infected patients”
Prof Mark Enright,University of Bath
And the researchers say there is as yet no evidence that dietary B3 or supplements could prevent or treat bacterial infections.
The researchers say B3 appears to be able to "turn on" certain antimicrobial genes, boosting the immune cells' killing power.
Prof Adrian Gombart, of Oregon State University's Linus Pauling Institute, who worked on the research, said: "This is potentially very significant, although we still need to do human studies.
"Antibiotics are wonder drugs, but they face increasing problems with resistance by various types of bacteria, especially Staphylococcus aureus.
"This could give us a new way to treat Staph infections that can be deadly, and might be used in combination with current antibiotics.
"It's a way to tap into the power of the innate immune system and stimulate it to provide a more powerful and natural immune response."
Prof Mark Enright, of the University of Bath, said: "Neutrophils are really the front line against infections in the blood and the use of nicotinamide seems safe at this dose to use in patients as it is already licensed for use.
"This could cause a major change in treatment for infections alongside conventional antibiotics to help bolster patients immune system.
"I would like to see in patient clinical trials but cannot see why this couldn't be used straight away in infected patients."

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Vitamin B3 (Niacin)


Vitamin B3 (Niacin)

Overview:

Vitamin
B3 is one of 8 B vitamins. It is also known as niacin (nicotinic acid) and has 2 other forms, niacinamide (nicotinamide) and inositol hexanicotinate, which have different effects from niacin.
All B vitamins help the body to convert food (carbohydrates) into fuel (glucose), which is used to produce energy. These B vitamins, often referred to as B complex vitamins, also help the body use fats and protein. B complex vitamins are needed for healthy skin, hair, eyes, and liver. They also help the nervous system function properly.
Niacin also helps the body make various sex and stress-related hormones in the adrenal glands and other parts of the body. Niacin helps improve circulation.
All the B vitamins are water-soluble, meaning that the body does not store them.
You can meet all of your body's needs for B3 through diet. It is rare for anyone in the developed world to have a B3 deficiency. In the United States, alcoholism is the main cause of vitamin B3 deficiency.
Symptoms of mild deficiency include indigestion, fatigue, canker sores, vomiting, and depression. Severe deficiency can cause a condition known as pellagra. Pellagra is characterized by cracked, scaly skin, dementia, and diarrhea. It is generally treated with a nutritionally balanced diet and niacin supplements. Niacin deficiency also causes burning in the mouth and a swollen, bright red tongue.
Very high doses of B3, available by prescription, have been studied to prevent or improve symptoms of the following conditions. However, at high doses niacin can be toxic. You should not take doses higher than the Recommended Daily Allowance except under your doctor's supervision. Researchers are trying to determine if inositol hexanicotinate has similar benefits without serious side effects, but so far results are preliminary.
High Cholesterol
Niacin -- but not niacinamide -- has been used since the 1950s to try to lower elevated LDL ("bad") cholesterol and triglyceride (fat) levels in the blood. However, side effects can be unpleasant and even dangerous. High doses of niacin cause flushing of the skin, stomach upset (which usually subsides within a few weeks), headache, dizziness, and blurred vision. There is an increased risk of liver damage. A time-release form of niacin reduces flushing, but its long-term use is associated with liver damage. In addition, niacin can interact with other cholesterol-lowering drugs (see "Possible Interactions"). You should not take niacin at high doses without your doctor's supervision.
Atherosclerosis and Heart Disease
In one study, men with existing heart disease slowed down the progression of atherosclerosis by taking niacin along with colestipol. They had fewer heart attacks and deaths, as well.
In another study, people with heart disease and high cholesterol who took niacin along with simvastatin (Zocor) had a lower risk of having a first heart attack or stroke. Their risk of death was also lower. In another study, men who took niacin alone seemed to reduce the risk of having a second heart attack, although it did not reduce the risk of death.
Diabetes
Some evidence suggests that niacinamide (but not niacin) might help delay the time that you would need to take insulin in type 1 diabetes. In type 1 diabetes, the body's immune system mistakenly attacks the cells in the pancreas that make insulin, eventually destroying them. Niacinamide may help protect those cells for a time, but more research is needed to tell for sure.
Researchers have also looked at whether high-dose niacinamide might reduce the risk of type 1 diabetes in children at risk for the disease. One study found that it did, but another, larger study found it did not protect against developing type 1 diabetes. More research is needed to know for sure.
The effect of niacin on type 2 diabetes is more complicated. People with type 2 diabetes often have high levels of fats and cholesterol in the blood. Niacin, often along with other drugs, can lower those levels. However, niacin may also raise blood sugar levels, which is particularly dangerous for someone with diabetes. For that reason, anyone with diabetes should take niacin only when directed to do so by their doctor, and should be carefully monitored for high blood sugar.
Osteoarthritis
One preliminary study suggested that niacinamide may improve arthritis symptoms, including increasing joint mobility and reducing the amount of nonsteroidal anti-inflammatory drugs (NSAIDs) needed. More research is needed.
Other
Alzheimer's disease -- Population studies show that people who get higher levels of niacin in their diet have a lower risk of Alzheimer's disease. No studies have evaluated niacin supplements, however.
Cataracts -- One large population study found that people who got a lot of niacin in their diets had a lower risk of developing cataracts.
Skin conditions -- Researchers are studying topical forms of niacin as treatments for rosacea, aging, and prevention of skin cancer, although it's too early to know whether it is effective.
Researchers are also studying the use of vitamin B3 in treating ADHD, migraines, dizziness, depression, motion sickness, and alcohol dependence. But there is no evidence that it helps treat any of these conditions.

Dietary Sources:

The best food sources of vitamin B3 are found in beets, brewer's yeast, beef liver, beef kidney, fish, salmon, swordfish, tuna, sunflower seeds, and peanuts. Bread and cereals are usually fortified with niacin. In addition, foods that contain tryptophan, an amino acid the body coverts into niacin, include poultry, red meat, eggs, and dairy products.

Available Forms:

Vitamin B3 is available in several different supplement forms: niacinamide, niacin, and inositol hexaniacinate. Niacin is available as a tablet or capsule in both regular and timed-release forms. The timed-release tablets and capsules may have fewer side effects than regular niacin. However, the timed-release versions are more likely to cause liver damage. Regardless of which form of niacin you're using, doctors recommend periodic liver function tests when using high doses (above 100 mg per day) of niacin.

How to Take It:

Daily recommendations for niacin in the diet of healthy individuals are listed below.
Generally, high doses of niacin are used to control specific diseases. Such high doses must be prescribed by a doctor, who will have you increase the amount of niacin slowly, over the course of 4 - 6 weeks, and take the medicine with meals to avoid stomach irritation.
Pediatric
  • Infants birth - 6 months: 2 mg (adequate intake)
  • Infants 7 months - 1 year: 4 mg (adequate intake)
  • Children 1- 3 years: 6 mg (RDA)
  • Children 4 - 8 years: 8 mg (RDA)
  • Children 9 - 13 years: 12 mg (RDA)
  • Boys 14 - 18 years: 16 mg (RDA)
  • Girls 14 - 18 years: 14 mg (RDA)
Adult
  • Men 19 years and older: 16 mg (RDA)
  • Women 19 years and older: 14 mg (RDA)
  • Pregnant women: 18 mg (RDA)
  • Breastfeeding women: 17 mg (RDA)

Precautions:

Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable health care provider.
High doses (50 mg or more) of niacin can cause side effects. The most common side effect is called "niacin flush," which is a burning, tingling sensation in the face and chest, and red or flushed skin. Taking an aspirin 30 minutes prior to the niacin may help reduce this symptom.
At the very high doses used to lower cholesterol and treat other conditions, liver damage and stomach ulcers can occur. Your health care provider will regularly check your liver function through a blood test.
People with a history of liver disease, kidney disease, or stomach ulcers should not take niacin supplements. Those with diabetes or gallbladder disease should do so only under the close supervision of their doctor.
Stop taking niacin or niacinamide at least two weeks before a scheduled surgery.
Niacin and niacinamide may make allergies worse by increasing histamine.
People with low blood pressure should not take niacin or niacinamide because they may cause a dangerous drop in blood pressure. Don' t take niacin if you have a history of gout.
People with coronary artery disease or unstable angina should not take niacin without their doctor' s supervision, as large doses can raise the risk of heart rhythm problems.
Taking any one of the B vitamins for a long period of time can result in an imbalance of other important B vitamins. For this reason, you may want to take a B complex vitamin, which includes all the B vitamins.

Possible Interactions:

If you are currently taking any of the following medications, you should not use niacin without first talking to your health care provider.
Antibiotics, Tetracycline -- Niacin should not be taken at the same time as the antibiotic tetracycline because it interferes with the absorption and effectiveness of this medication. All vitamin B complex supplements act in this way and should be taken at different times from tetracycline.
Aspirin -- Taking aspirin before taking niacin may reduce flushing from niacin, but take it only under your doctor's supervision.
Anti-seizure Medications -- Phenytoin (Dilantin) and valproic acid (Depakote) may cause niacin deficiency in some people. Taking niacin with carbamazepine (Tegretol) or mysoline (Primidone) may increase levels of these medications in the body.
Anticoagulants (blood thinners) -- Niacin may make the effects of these medications stronger, increasing the risk of bleeding.
Blood Pressure Medications, Alpha-blockers -- Niacin can make the effects of medications taken to lower blood pressure stronger, leading to the risk of low blood pressure.
Cholesterol-lowering Medications -- Niacin binds the cholesterol lowering medications known as bile-acid sequestrants and may make them less effective. For this reason, niacin and these medications should be taken at different times of the day. Bile-acid sequestrants include colestipol (Colestid), colesevelam (Welchol), and cholestyramine (Questran).
Statins -- Some scientific evidence suggests that taking niacin with simvastatin (Zocor) appears to slow down the progression of heart disease. However, the combination may also increase the likelihood for serious side effects, such as muscle inflammation or liver damage.
Diabetes Medications -- Niacin may increase blood sugar levels. People taking insulin, metformin (Glucophage), glyburide (Dibeta, Micronase), glipizide (Glucotrol), or other medications used to treat high blood glucose levels should monitor their blood sugar levels closely when taking niacin supplements.
Isoniazid (INH) -- INH, a medication used to treat tuberculosis, may cause a niacin deficiency.
Nicotine Patches -- Using nicotine patches with niacin may worsen or increase the risk of flushing associated with niacin.
These medications may lower levels of niacin in the body:
  • Azathioprine (Imuran)
  • Chloramphenicol (Chloromycetin)
  • Cycloserine (Seromycin)
  • Fluorouracil
  • Levodopa and carbidopa
  • Mercaptopurine (Purinethol)

Alternative Names:

Inositol hexaniacinate; Niacin; Niacinamide; Nicotinamide; Nicotinic acid
  • Reviewed last on: 8/31/2011
  • A.D.A.M. Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network (6/12/2011).

Supporting Research

AIM-HIGH Investigators. The role of niacin in raising high-density lipoprotein cholesterol to reduce cardiovascular events in patients with atherosclerotic cardiovascular disease and optimally treated low-density lipoprotein cholesterol Rationale and study design. The Atherothrombosis Intervention in Metabolic syndrome with low HDL/high triglycerides: Impact on Global Health outcomes (AIM-HIGH). Am Heart J. 2011 Mar;161(3):471-477.e2.
Bissett DL, Oblong JE, Berge CA, et al. Niacinamide: A B vitamin that improves aging facial skin appearance. Dermatol Surg. 2005;31:860-865; discussion 865.
Brown BG, Zhao XQ, Chalt A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med. 2001;345(22):1583-1592.
Cumming RG, Mitchell P, Smith W. Diet and cataract: the Blue Mountains Eye Study. Ophthalmology. 2000;107(3):450-456.
Draelos ZD, Ertel K, Berge C, et al. Niacinamide-containing facial moisturizer improves skin barrier and benefits subjects with rosacea. Cutis. 2005;76:135-141.
Elam M, Hunninghake DB, Davis KB, et al. Effects of niacin on lipid and lipoprotein levels and glycemic control in patients with diabetes and peripheral arterial disease: the ADMIT study: a randomized trial. Arterial Disease Multiple Intervention Trial. JAMA. 2000;284:1263-1270.
Garcia-Closas R. et al. Food, nutrient and heterocyclic amine intake and the risk of bladder cancer. Eur J Cancer. 2007;43(11):1731-40.
Goldberg A, Alagona P, Capuzzi DM, et al. Multiple-dose efficacy and safety of an extended-release form of niacin in management of hyperlipidemia. Am J Cardiol. 2000;85:1100-1105.
Guyton JR. Niacin in cardiovascular prevention: mechanisms, efficacy, and safety. Curr Opin Lipidol. 2007 Aug;18(4):415-20.
Jacques PF, Chylack LT Jr, Hankinson SE, et al. Long-term nutrient intake and early age related nuclear lens opacities. Arch Ophthalmol. 2001;119(7):1009-1019.
Kuzniarz M, Mitchell P, Cumming RG, Flood VM. Use of vitamin supplements and cataract: the Blue Mountains Eye Study. Am J Ophthalmol. 2001;132(1):19-26.
Mittal MK, Florin T, Perrone J, Delgado JH, Osterhoudt KC. Toxicity from the use of niacin to beat urine drug screening. Ann Emerg Med. 2007;50(5):587-90.
Nutrients and Nutritional Agents. In: Kastrup EK, Hines Burnham T, Short RM, et al, eds. Drug Facts and Comparisons. St. Louis, Mo: Facts and Comparisons; 2000:4-5.
Raja R, Thomas JM, Greenhill-Hopper M, Ley SV, Almeida Paz FA. Facile, one-step production of niacin (vitamin B3) and other nitrogen-containing pharmaceutical chemicals with a single-site heterogeneous catalyst. Chemistry. 2008;14(8):2340-8.
Sanyal S, Karas RH, Kuvin JT. Present-day uses of niacin: effects on lipid and non-lipid parameters. Expert Opin Pharmacother. 2007 Aug;8(11):1711-7.
Torkos S. Drug-nutrient interactions: a focus on cholesterol-lowering agents. Int J Integrative Med. 2000;2(3):9-13.
Wolerton: Comprehensive Dermatalogic Drug Therapy, 2nd ed. Philadelphia, PA: Saunders Elsevier. 2007.
Zhao H, Yang X, Zhou R, Yang Y. Study on vitamin B1, vitamin B2 retention factors in vegetables. Wei Sheng Yan Jiu. 2008;37(1):92-6.


Read more: http://www.umm.edu/altmed/articles/vitamin-b3-000335.htm#ixzz2520UrkZZ

tuberculosis in Africa, Asia, Europe and Latin America


* Eight country study finds high rates of drug resistance
* Resistant strains more costly to treat, often more fatal
* Almost 9 million people a year get TB, 1.4 million die (Adds expert comment on drug costs, vaccines)
By Kate Kelland
LONDON, Aug 30 (Reuters) - Scientists have found an alarming number of cases of the lung disease tuberculosis in Africa, Asia, Europe and Latin America that are resistant to up to four powerful antibiotic drugs.
In a large international study published in the Lancet medical journal on Thursday, researchers found rates of both multi drug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) were higher than previously thought and were threatening global efforts to curb the spread of the disease.
"Most international recommendations for TB control have been developed for MDR-TB prevalence of up to around 5 percent. Yet now we face prevalence up to 10 times higher in some places, where almost half of the patients ... are transmitting MDR strains," Sven Hoffner of the Swedish Institute for Communicable Disease Control, said in a commentary on the study.
TB is already a worldwide pandemic that infected 8.8 million people and killed 1.4 million in 2010.
Drug-resistant TB is more difficult and costly than normal TB to treat, and is more often fatal.
MDR-TB is resistant to at least two first-line drugs - isoniazid and rifampicin - while XDR-TB is resistant to those two drugs as well as a powerful antibiotic type called a fluoroquinolone and a second-line injectable antibiotic.
Treating even normal TB is a long process, with patients needing to take a cocktail of powerful antibiotics for six months. Many patients fail to complete their treatment correctly, a factor which has fuelled a rise in the drug-resistant forms.
Researchers who studied rates of the disease in Estonia, Latvia, Peru, the Philippines, Russia, South Africa, South Korea and Thailand found almost 44 percent of cases of MDR TB were also resistant to at least one second-line drug.
Tom Evans, chief scientific officer at Aeras, a non-profit group working to develop new TB vaccines, told Reuters treatment options for XDR-TB patients were "limited, expensive and toxic".
Treatments for drug-resistant TB can cost 200 times more than those for normal TB, he said in an emailed statement. They can also cause severe side effects like deafness and psychosis, and can take two years to complete, he added.
In the United States, MDR-TB treatment can cost $250,000 or more per patient, and in many poorer countries costs can be catastrophic to health systems and patients' families.
"Without a robust pipeline of new drugs to stay one step ahead, it will be nearly impossible to treat our way out of this epidemic," Evans said.
SPREADS THROUGH AIR
Tracy Dalton from the United States Centers for Disease Control and Prevention, who led the Lancet study, said that so far, XDR-TB has been reported in 77 countries worldwide.
"As more individuals are diagnosed with, and treated for, drug-resistant TB, more resistance to second-line drugs is expected to emerge," she said.
The spread of these drug-resistant strains was "particularly worrisome" in areas with poor healthcare resources and limited access to effective drugs, she added.
TB is a bacterial infection that destroys patients' lung tissue, making them cough and sneeze and spread germs through the air. Experts say anyone with active TB can easily infect another 10 to 15 people a year.
The World Health Organisation (WHO) predicts more than 2 million people will contract MDR TB by 2015.
A report by non-governmental organisations in March said a $1.7 billion shortfall in funds to fight TB over the next five years meant 3.4 million patients would go untreated and gains made against the disease will be reversed.
In their research, Dalton and colleagues found rates of resistance varied widely between countries.
Overall, resistance to any second-line drug was detected in nearly 44 percent of patients, ranging from 33 percent in Thailand to 62 percent in Latvia.
In about a fifth of cases, they found resistance to at least one second-line injectable drug. This ranged from 2 percent in the Philippines to 47 percent in Latvia.
XDR-TB was found in 6.7 percent of patients overall. Rates in South Korea, at 15.2 percent, and Russia at 11.3 percent, were more than twice the WHO's global estimate of 5.4 percent at that time. (Editing by Andrew Heavens)

Wednesday, 29 August 2012

Personal care costs rise by 150% in seven years


Personal care costs rise by 150% in seven years

Generic image of pensionersAbout 77,000 people now receive help in their own homes and in care homes

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The cost of providing free personal care to people in their own homes has risen by more than 150% in seven years, according to the Scottish government.
Helping people with personal care such as washing and dressing cost £342m in 2010-11, up from £133m in 2003-04.
The government said the rise reflected the fact that an increasing proportion of older people were cared for at home rather than in hospital or care homes.
Personal care costs for people in care homes rose by 25%, from £86m to £108m.
Personal or nursing care payments are available to self-funding care home residents who have assets, including property, worth more than £23,500.
The number of people receiving these payments to help pay their care home fees increased steadily in the first few years of the policy. Currently, just under a third of all older people in care homes receive the payments.
The number of people receiving free personal care at home has also increased by 42% over the same period, from 32,870 in 2003-04 to 46,720 in 2010-11.

Start Quote

A responsible government in Scotland cannot ignore the facts, kidding everyone on that everything and anything is affordable”
Jackson CarlawScottish Tory health spokesman
Free personal care was introduced by the Scottish government in 2002, and the policy was reviewed in 2008.
About 77,000 people in Scotland now receive help in their own homes and in care homes compared with 64,000 when the policy was first introduced.
Jackson Carlaw, Scottish Conservative health spokesman and deputy leader MSP, said: "If the SNP wants to continue funding free personal care, then it has to be far less casual in extending other entitlements and refusing to find ways to make them more sustainable.
"That is why we opposed free prescriptions, and why we want to align free transport to the pensionable age in future.
"A responsible government in Scotland cannot ignore the facts, kidding everyone on that everything and anything is affordable. We all know that there is an unprecedented demographic challenge waiting around the corner."
Jackie Baillie, Scottish Labour's health speaker, said her party was fully committed to the policy.
But she added: "My fear is the quality of care we provide for people will be compromised as a result of the strain on finances and the elderly and the vulnerable will pay another kind of price in a drop in standards of care.
"We have previously suggested creating a National Care Service to join up budgets and set a minimum standard of care but are open to working with the Scottish government to look at ways to ensure personal care is sustainable in the long-term."
'Greatly valued service'
Health Secretary, Nicola Sturgeon, said: "These figures show that each year an increasing number of older people continue to benefit from free personal and nursing care.
"This reflects the Scottish government's focus on more intensive support to frail older people at home or in a homely setting, as well as the continuing shift in the balance of care towards providing care at home.
"We are fully committed to the funding of free personal care for the elderly, a service greatly valued by the people of Scotland.
"The challenges posed by an ageing population demonstrate why we want to see health and social care for adults delivered in an integrated way by NHS.

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Sunday, 26 August 2012

twice the number of measles cases


Measles cases 'almost double' after outbreaks


Measles is on the rise
There have been almost twice the number of measles cases in England and Wales in the first six months of this year compared with the same period last year, official figures show.
The figure had risen from 497 to 964, the Health Protection Agency said.
MeaslesThere are currently significant measles outbreaks in Merseyside and Sussex.
The agency is urging parents to ensure children are up to date with their measles, mumps and rubella (MMR) vaccinations before the school begins.
Measles can cause serious illness and can, in some cases, be fatal.
Complications can include meningitis and encephalitis - inflammation of the lining of the brain. Rarer disorders of the eye, heart and nervous system can also develop.
Rubella, known as German measles, has also increased, with 57 cases reported between January and June in England and Wales - more than the annual totals for each of the previous nine years.
Most cases are linked to travel to other European countries.

Latest data on immunisations across England shows uptake rates of 93% for the first MMR jab and 87% for the second.
It is usually a mild infection. But if a woman becomes infected in early pregnancy, it can cause birth defects.
In Wales, the figures are 92% and 87%.
The first dose of the MMR vaccine should ideally be given to children between 12 to 13 months of age.
They are given the second dose before they start school, usually between three and five years of age, although it can be given three months after the first.
'Best protection'
Dr Mary Ramsay, head of immunisation at the Health Protection Agency, said: "Measles can be very serious and parents should understand the risks associated with the infection, which in severe cases can result in death.
"Although uptake of the MMR has improved in recent years some children do not get vaccinated on time and some older children, who missed out when uptake was lower, have not had a chance to catch up.
"Therefore, there are still enough people who are not protected to allow some large outbreaks to occur among unvaccinated individuals."
She added: "It's vital that children receive both doses of the MMR vaccination and ahead of returning to school after the holidays, we are urging parents to ensure their children have received the two doses, which will provide the best protection against the risks associated with measles, mumps and rubella."
The HPA is advising parents to check with their GP to see if their child has had both doses of MMR.

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