Kim’s public health blog

Researchers from Weill Cornell Medical College have published results showing that a new contraceptive device may also effectively block the transmission of the HIV virus. Findings show that the device prevents infection by the HIV virus in laboratory testing. The promising results are published in the most recent issue of the journal AIDS. The new device is a vaginal ring that releases multiple types of non-hormonal agents and microbicides, which would prevent conception as well as sexually transmitted HIV infection. Worldwide, there are about 5 million new infections and 3 million deaths per year due to HIV/AIDS. If proven successful in future clinical trials, the new device could empower women to effectively and conveniently protect themselves from unintended pregnancy and sexually transmitted infection. The ring may also someday represent a novel method to prevent STIs for those with aversion to currently available methods, with hormonally derived active agents, or with allergies to latex condoms.

It is not often a reason to be excited when a new paper on biochemistry is published but; From McGill University a offers new hope for the early diagnosis and treatment of Alzheimer’s disease. In a study published in the Journal of Biological Chemistry on May 15, Dr. Hemant Paudel, his PhD student Dong Han and postdoctoral fellows Hamid Qureshi and Yifan Lu, report that the addition of a single phosphate to an amino acid in a key brain protein is a principal cause of Alzheimer’s. Identifying this phosphate, one of up to two-dozen such molecules, could make earlier diagnosis of Alzheimer’s possible and might, in the longer term, lead to the development of drugs to block its onset. “The impact of this study is twofold,” said Paudel, “We can now do brain imaging at the earliest stages of the disease. We don’t have to look for many different tau phosphates, just this single phosphate. The possibility of early diagnosis now exists. “Second, the enzyme which puts this phosphate on the tau can be targeted by drugs, so therapies can be developed. This discovery gives us, for the first time, a clear direction towards the early diagnosis and treatment of Alzheimer’s.”

Promoting the health of young children, before five years of age, could save society up to $65 billion in future health care costs, according to an examination of childhood health conducted by researchers at the Johns Hopkins Bloomberg School of Public Health. “Our review found convincing evidence that the four health problems we studied—early life tobacco exposure, unintentional injury, obesity and mental health—constitute significant burdens on the health of preschool-age children and are antecedents of health problems across the life span,” said Bernard Guyer, MD, lead author of the study and the Zanvyl Kreiger Professor of Children’s Health with the Bloomberg School’s Department of Population, Family and Reproductive Health.

The Los Angeles Times reports that “the cesarean is now routine. The most common operation in the US, it is performed in 31 percent of births, up from 4.5 percent in 1965.” But, “with that surge has come an explosion in medical bills, an increase in complications — and a reconsideration of the cesarean as a sometimes unnecessary risk.” According to the Times, “It is a big reason childbirth often is held up in healthcare reform debates as an example of how the intensive and expensive US brand of medicine has failed to deliver better results and may, in fact, be doing more harm than good.” Comment: Many physicians have been concered abou the rising rate of cesarian deliveries for at least 20 years.

Accoreding to the the Los Angeles Times “The longest-running heart health study in the world, the 60-year-old Framingham Heart Study, continues to mine its vast data set for causes or signs of heart trouble.” Framingham “began recruiting subjects in the Massachusetts town in 1948,” and “six decades on, there is still plenty for Framingham to do.” Researchers are now “seeking genes and additional blood-borne molecules that can predict cardiovascular problems,” while “others mine Framingham’s detailed, long-term data to study noncardiac health concerns, such as stroke and dementia.” As part of the Systems Approach to Biomarker Research project, scientists are searching “for new biomarkers that indicate risk for cardiovascular disease.” Meanwhile, another “goal is to identify people likely to suffer a first heart attack within a few months or a year.”

The nay-sayers are girding up for battle with misinformation about the need to change the US Health Care System. The first two sentances of an editorial in this week’s Lancet shoud be buirned into all our memories and the full editorial read. “The USA has the highest health care expenditure of any industrialized nation (currently US$2•5 trillion or roughly 20% of GDP), yet it ranks 29th in infant mortality and 45th in life expectancy; a third of every health-care dollar is spent on bureaucracy. 46 million US citizens do not have health insurance (costing $123 billion annually in acute emergency care). For those who are insured, health resources are controlled by third parties (employers and insurance companies). Most personal bankruptcies are caused by health-care debts.”

ScienceDaily (May 14, 2009) — New research supports the findings of a landmark drug comparison study published in 2002 in which a diuretic drug or “water pill” outperformed other medications for high blood pressure. A scientific team including investigators from The University of Texas Health Science Center at Houston reports the findings in the May 11 issue of the Archives of Internal Medicine. Comment: Further studies looking for weaknesses in the original research have confirmed that diuretics still outperform other medicines in controlling blood pressure. I wonder how much disability and death could have been avoided is we had kept the diuretics (available for 50+ years) as the base of our armamentarium.

With the federal government putting $1.1 billion into comparative-effectiveness research, two Baylor College of Medicine researchers advocate investing in finding ways to put that science into practice in doctors’ offices and clinics across the nation. “We need to pay as much attention as to how the evidence is put into practice as to the evidence itself,” said Dr. Laura A. Petersen, chief of the section of health services research in the department of medicine at BCM and director of the Veterans Affairs Health Services Research and Development Center of Excellence. Petersen, and Dr. Aanand D. Naik, an assistant professor of medicine discussed the need for a new emphasis in implementing the results of comparative-effectiveness research in a Perspective in the current issue of the New England Journal of Medicine.

ScienceDaily (May 4, 2009) — Increased sexual activity and alcohol consumption were associated with an increased risk of developing urinary tract infections (UTIs), and college-aged women experiencing urinary frequency or urgency should seek medical care to treat what may be their first urinary tract infection (UTI), according to new research presented at the 104th Annual Scientific Meeting of the American Urological Association. [Symptoms and risk factors associated with first UTI in college-aged women: a prospective cohort study. The Journal of Urology, 2009; 181 (4): 142]

Researchers are pioneering the use of DNA “barcodes” to map menacing mosquito species in West Africa that spread lymphatic filariasis, commonly known as elephantiasis. The ability to precisely identify mosquito species is a promising advance in the battle against LF, an often disfiguring disease that today threatens 1 billion people across roughly 80 countries.[ JRS Biodiversity Foundation (2009, May 4). DNA Barcoding Of Mosquito Species Deployed In Bid To End Elephantiasis. ScienceDaily.]