Categories
Cardiovascular
Diagnostics
Endocrinology
Health Insurance
Medical Devices
Mental Health
Nutrition
Oncology
Public Health
Sexual Health
rubber dildos.
Popular Articles

Hospital Disaster Potential Highighted By Swedish Study
Factors that lead to emergency department overcrowdings, ambulance diversions and other incidents that endanger patient safety have been revealed. A study published in BioMed Central"s open access Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine has shown that reductions in the number of hospital beds and downsizing or closure of emergency departments may create a dangerous loss of "surge capacity".
diet pills
Nanosignals Of Trouble From 'Normal' Cells Far From Cancer
A new Northwestern University-led study of human colon, pancreatic and lung cells is the first to report that cancer cells and their non-cancerous cell neighbors, although quite different under the microscope, share very similar structural abnormalities on the nanoscale level.
News of the day
Meeting Addresses MTCT Of HIV In Africa
Health officials recently held a regional consultation in Kenya to examine mother-to-child HIV transmission services and pediatric HIV/AIDS care in nine Eastern and Southern African countries, IRIN/PlusNews reports. The consultation -- hosted by UNICEF, UNAIDS and the World Health Organization -- included representatives from Ethiopia, Kenya, Malawi, Mozambique, South Africa, Swaziland, Tanzania, Uganda and Zambia. The meeting addressed issues in MTCT prevention services -- including the continued use of single-dose nevirapine instead of more effective combination therapies, as well as delays in diagnosing and initiating treatment -- that are weakening prevention programs in focus countries. According to IRIN/PlusNews, 70% of pregnant women in Eastern and Southern African countries are seen by a health care provider at least once during pregnancy. However, 43% of HIV-positive pregnant women have a health care worker present during labor who can administer PMTCT treatment. In Uganda, a national policy calls for all sub-county level health facilities to provide PMTCT services, but only 53% offer such services because of health worker shortages. Janet Kayita, regional PMTCT adviser for UNICEF, said, "We are doing a bad job of testing women for HIV and then following them up, and an even worse job of ensuring that infants receive appropriate prevention and treatment services." She added that national PMTCT guidelines have not reached local levels. "These policies must become a reality for the people they were designed to help," Kayita said, adding that primary health care systems at all levels must be strengthened (IRIN/PlusNews, 5/25).Some officials at the meeting called on African governments to reach 80% of pregnant women, mothers and children with services; reduce by 50% the number of women and infants who do not receive follow-up care; and double the number of HIV-positive children who receive antiretroviral treatment. Xinhuanet reports that prevention services currently reach about 50% of pregnant women in all Eastern and Southern African countries. At the close of the consultation, officials issued a set of recommendations for meeting PMTCT goals, including increased community involvement in prevention programs; reduced workloads for health workers; and increased coverage of and compliance with PMTCT regimens. In addition, the experts urged governments to prioritize regions with high HIV burdens and strengthen data management to better understand trends (Ooko, Xinhuanet, 5/25). James Kamau, coordinator of the Kenya Treatment Access Movement, recommended that more women in the country deliver in hospitals in order to ensure that they receive PMTCT services (Mwaniki, Daily Nation, 5/25). David Alnwick, a UNICEF regional adviser, said, "It is critical at this juncture, when many countries are faced with shrinking budgets and competing demands, that we do not lose the momentum of what needs to be done to create an AIDS-free generation" (Xinhuanet, 5/25).
Cardiovascular

New Study Highlights Threat Of Resistance To Artemisinin-Based Anti-Malarial Drugs

Malaria parasites in western Cambodia have become resistant to artemisinin-based therapies, the first-line treatment for malaria, according to a study published in the New England Journal of Medicine. Resistance to the drugs makes them less effective and could eventually render them obsolete, putting millions of lives at risk. Signs of artemisinin resistance have been reported in the region already, but this new research is the first detailed study of the problem. The study was funded by the Wellcome Trust, the Li Ka Shing Foundation, and the Global Malaria Programme of the World Health Organisation (through grants from the Bill and Melinda Gates Foundation and the Western Pacific Regional Office). Malaria is a potentially deadly disease that kills more than a million people each year, mainly young children and pregnant women. It is caused by malaria parasites, which are injected into the bloodstream by infected mosquitoes. The most deadly form, Plasmodium falciparum, is responsible for nine out of ten deaths from malaria. The most effective anti-malarial drug is artemisinin, derived from Artemisia annua, also known as sweet wormwood, which had been used in Chinese medicine for centuries under the name Qinghaosu. It was rediscovered in the 1970s, evaluated first in South-East Asia, and eventually accepted as an essential component of antimalarial treatment in the past few years. The artemisinin derivatives have the advantage over other anti-malarial drugs, such as chloroquine and mefloquine, in having few side effects and - until now - malaria parasites have no resistance against it. Although the drugs - most commonly in the form of the derivative artesunate - can be used on their own as a monotherapy, fears over the possible development of resistance mean that they are usually given in conjunction with one or more other drugs as artemisinin-based combination therapies (ACTs), now recommended by the WHO as the first-line treatment for uncomplicated falciparum malaria in all endemic countries. Following increasing reports that the efficacy of artemisinin monotherapies and combination therapies were declining in western Cambodia, researchers at the Wellcome Trust-Mahidol University Oxford Tropical Medicine Research Programme, based in Bangkok, studied the susceptibility of P. falciparum parasites to the drugs. The Research Programme is a collaboration between Mahidol University, Bangkok, and the University of Oxford, supported by the Wellcome Trust. The researchers studied forty patients in each of Pailin, western Cambodia, and Wang Pha, north-western Thailand. In two open-label, randomised trials, each was given the relevant dosage appropriate to their body weight of either artesunate or a combination of artesunate and mefloquine. On average, patients in Thailand were clear of parasites in 48 hours; in western Cambodia this took 84 hours - in other words, it took almost twice as long to clear the parasites in Cambodia as it did in Thailand. During the treatment period, as the number of parasites in the blood falls, so the infection should clear. Its recurrence can be a sign that the drug treatment is not working effectively. In this study, out of the twenty patients treated with the monotherapy in each country, there were recurrences of the infection in six patients in western Cambodia compared to just one person in Thailand. Of the twenty patients treated with the combination therapy, infection recurred in two patients in Cambodia compared to one in Thailand. These results again suggest that artemisinin was less effective on the Cambodian parasites. "Our study suggests that malaria parasites in Cambodia are less susceptible to artemisinin than those in Thailand," says Dr Arjen Dondorp, lead author of the study. "This means that it takes longer to kill the parasites. Artemisinin should clear the parasites at an early stage, preventing them further maturing and reproducing. When the drug"s action is impaired, it becomes more difficult to eliminate the parasites from the body. "With artesunate losing its potency, ACTs rely much more on the weaker partner drug, increasing the risk that resistance also evolves towards the partner drug. This has very important consequences for the lifespan of ACTs. Losing ACTs would be a disaster for malaria control." Artemisinin-based drugs have been in use in western Cambodia for around thirty years and the country was one of the earliest to switch to ACTs in 2001. However, the majority of patients in the region receive their medication from the private sector, which is less well regulated. Patients in the private sector are frequently provided with monotherapies or incomplete treatment courses. Added to this is the problem of substandard or counterfeit drugs with sub-clinical doses of artemisinin. This extended period of sub-optimal use of artemisinin-based drugs may have contributed to the emergence of resistance. With signs of artemisinin-resistance occurring in other areas of Cambodia and Thailand, Dr Dondorp says swift action is required to contain the spread. "Preventing the spread of resistant parasites when they emerge is crucial," he says. "The use of combination therapies is very important for this. I would like to see a ban on artesunate monotherapy except for specific cases." Professor Nick White, co-author of the study and Chair of the Wellcome Trust South-East Asia Programme, believes the implications of the findings are potentially huge. "Artemisinins are essential weapons in our war against malaria," he says. "If they become ineffective, we have no immediate replacement. The consequences could be devastating. Elimination of malaria will not be possible and millions of lives could be lost." Craig Brierley Wellcome Trust


Add your comment:
Name:
Site address: http://
Your message:
Enter today\\\\'s date, 2 digits
(spam protection):

© Copyright 2009