Thursday, November 29, 2018

CDC updates its guidance for prevention of sexually transmitted Zika infection


The Center for Disease Control (CDC) recently issued an interim update to its guidance for Preconception Counseling and Prevention of Sexual Transmission of Zika Virus for Men with Possible Zika Virus Exposure. The recommendations were published in the weekly Morbidity and Mortality Weekly Report (MMWR).

Zika infection in pregnancy may cause multiple abnormalities including congenital Zika syndrome which includes– severe anencephaly, decreased brain tissue, macular scarring and focal pigmentary retinal mottling, clubfoot or arthrogryposis, and hypertonia restricting body movement soon after birth.

Zika infection is transmitted primarily through the bite of infected Aedes aegypti mosquito or through unprotected sex with an infected partner. Since 2015, 52 confirmed cases of sexual transmitted Zika infection have been known in the US. In most of the cases, the transmission occurred from infected men to women, although some instances of men to men and women to men transmission are also known.

The recent CDC update is for men with a possible Zika exposure who are planning a pregnancy with their partners or who want to prevent the sexual transmission of Zika anytime.

CDC now recommends that men with Zika exposure should wait for a minimum of 3 months after the onset of Zika Symptoms (symptomatic) or after Zika exposure(asymptomatic) before they plan a pregnancy with their partners.

If the couple is not planning a pregnancy, they should use condoms or abstain from sex for three months to prevent the sexual transmission of infection. 

Recommendations for men with possible Zika virus exposure whose partner is pregnant remains unchanged, they are advised to consistently and correctly use condoms during sex or abstain from sex for the duration of the pregnancy.


Tuesday, November 27, 2018

China claims to have created the World’s first designer twins



China’s claim of using gene-editing to create the World’s first designer babies have stirred outrage in the scientific world. The researchers fear that it will stall their efforts to translate gene-editing technology into safe treatments for genetic diseases.

He Jiankui is a Stanford and Rice University-trained physicist and claims to have used CRISPR-Cas9 to delete the embryos’ CCR5 gene (C-C motif chemokine receptor 5), which is linked to resistance to HIV infection and the twins were born a few weeks ago with innate immunity to HIV, the virus that causes AIDS.


He Jiankui

In 2010, when Jiankui was a Rice University student, he already published a paper on details about gene-editing using the bacterial immune system CRISPR. It was well before Geneticist Jennifer Doudna co-invented the groundbreaking current technology for editing genes, called CRISPR-Cas9.

He currently works at the Southern University of Science and Technology of China in Shenzhen and has posted videos to YouTube about his editing techniques. The research is not yet published in a peer-reviewed journal and is, however, yet to be verified by outside scientists and researchers.

The news stunned the scientist and researchers all over the globe as they prepare to gather in Hongkong for the Second International Summit on Human Genome Editing from November 27-29, 2018. David Baltimore, Nobel laureate and chair of the organizing committee said, “I don’t know the details.”

 “We don’t know what will be said,” when He speaks at a session on human embryo editing on Tuesday, November 27, 2018.

There are two main issues with the existing gene-editing technique if used to create ‘designer babies’ in the real world. The first is mosaicism, in which the edited gene does not make it way into every cell of the embryo and second are off-target effects, where other parts of the genome may get deleted accidentally, and the consequences remain unknown.




Before genome editing is used as medical treatment, it is essential that the issues of mosaicism and off-target effects are resolved. Long-term follow-up of babies who have had gene-editing done is needed to know about long-term effects.

It is also unclear that why this particular gene was editing in the twins, but reports coming out of China suggest that the father was HIV positive, but his infection was under control and mother was HIV negative. The scientists also fail to understand that why he chose the HIV gene for editing, as there already exist proven treatments to prevent HIV-positive parents from infecting their children.
There are also specific risks of having a disabled CCR5 gene, which includes a higher risk of West Nile virus infection and dying from Influenza.

The summit’s organizing committee issued a statement Monday saying they had only just learned of He’s research in Shenzhen, China. “Whether the clinical protocols that resulted in the births in China conformed with the guidance” of leading scientific bodies for conducting clinical trials of heritable genome editing “remains to be determined,” the statement said. “We hope that the dialogue at our summit further advances the world’s understanding of the issues surrounding human genome editing. Our goal is to help ensure that human genome editing research is pursued responsibly, for the benefit of all society.”

Meanwhile, Chinese officials have condemned He’s research and strongly oppose the use of gene-editing technology in humans. gene-edited babies are prohibited in China. The Ethical Guiding Principles for the Research of Human Embryonic Stem Cell which was published by the Chinese government in 2003 states that scientists are allowed to conduct genetic editing to human embryos only for research purposes, but the time for their in-vitro breeding shall not exceed 14 days from the date of fertilization or nucleus transplant.

Here is a YouTube video showing He giving information about the twins





Friday, November 23, 2018

Barco launches 27″ 4K Surgical Monitor for the most stunning display in the operating room


Belgium based global technology leader Barco recently launched its 27″ 4K Surgical Monitor for operating room to display the best pictures during the interventional procedures. The MDSC-8427 is specially designed to deliver impeccable quality for 4K visualization of high-quality images that are precise, bright and unparallel color quality.

This surgical display is designed keeping in mind the recent rise of 4K endoscopes and room cameras and matches all the current and new installs. It can also replace the Full HD screen on the surgical cart or dual displays on the monitor arm of a surgical boom.

The monitor comes with a variety of broad future-proof connectivity options like DP, HDMI, 12G-SDI, Quad-SDI, and IP to enable the surgeons to watch a wide array of digital video sources like endoscopic video, patient and surgery information, room and boom camera, and more. The system can display multiple sources at the same time for comprehensive information in the OR.

The wide color gamut and advanced color calibration algorithms result in an accurate, true to life color reproductions of images for real-time imaging during endoscopic surgeries. This results in the accurate display from deep reds to the blackest blacks, which can be viewed with equal precision from any angle in the operating room.




The user-friendly interface displays images in both front and back – making it easy to operate and adjust the viewing as per the preference of the surgical team and the different procedures.

The MDSC-8427 is equipped with an automated failover feature to ensure safe surgery. The smooth, sleek design and splash proof housing make it easy to sterilize and maintain good hygiene.

“The new MDSC-8427 is a first in our next generation of 4K displays for the operating room,” says Johan Stockman, Barco’s VP surgical imaging. “Careful consideration went into the new design. We wanted to create a display that combines surgical aesthetics with surgical precision. This new paradigm of display design shows how fine form can meet function in the operating room”.

Here is a video about various features of 4K in the operating room







Wednesday, November 21, 2018

Simple sonographic marker helps predicts the risk of intra-abdominal adhesions in patients with previous Cesarean section


A simple sonographic marker ‘sliding sign’ of the uterus during the last trimester of pregnancy can help physicians to distinguish between patients who have a high probability of intraabdominal adhesions during repeat cesarean section reports the results of an observational study published in the Journal of Ultrasound in Obstetrics & Gynecology (UOG)

Presence of Intra-abdominal adhesions complicate the repeat surgical procedure and increase the chances of bladder and bowel trauma and bleeding. About 24% to 46% of patients will develop adhesions after one cesarean and the rate increases to 43% to 75% at the third, and up to 83% at the fourth cesarean delivery.

Italian researcher Baron and colleagues selected 59 patients who had a history of one or more previous cesarean section and evaluated them during the third trimester of ongoing pregnancy by abdominal ultrasound. To know about the risk of the presence of adhesions, the researcher looked at the sliding of gravid uterus under the inner part of the fascia of abdominal muscles.

Women who demonstrated easy and obvious sliding during deep breathing were predicted to be at low to moderate risk of the presence of intraabdominal adhesions (positive sliding sign), while in women whom the sliding was very little or absent (negative sliding sign), were at high risk of severe adhesions.



The prediction was confirmed at surgery, 16 out of 19 women who displayed a negative ‘sliding sign’ had severe intra-abdominal adhesions while 35 out of 40 women with positive ‘sliding sign’ had very few adhesions.

The sensitivity and specificity of the sliding sign in predicting the presence of intra‐abdominal adhesions in women undergoing repeat CS were 76.2% and 92.1%, respectively.

Thus, a simple sonographic sign can help physicians to know about the patient’s risk of having adhesions and be prepared for adhesions related complications during the repeat cesarean delivery.

Here is UOGJournal video clip illustrating the simple sonographic marker ‘sliding sign.’



Abstract 

Monday, November 19, 2018

FDA grants fast review for Roche's Tecentriq in tough-to-treat Triple Negative Breast cancer



Roche/Genentech’s new drug Tecentriq (atezolizumab) wins FDA priority review as a part of the regimen for the treatment of tough-to-treat Triple Negative Breast Cancer (TNBC). The drug will be used in combination with Celgene chemo med Abraxane (nab-paclitaxel) in previously untreated patients whose tumors express biomarker PD-L1.

A Priority Review designation is granted to medicines that the FDA has determined to have the potential to provide significant improvements in the treatment, prevention or diagnosis of a disease.

Triple-negative breast cancer is the term used to describe breast cancers that lack estrogen- and progesterone-receptor expression and do not overexpress human epidermal growth factor receptor 2 (HER2). It is more aggressive and harder to treat, it is also more likely to spread and recur. Approximately 15% of breast cancers are triple-negative based on the results of diagnostic tests.

The company’s supplemental Biologics License Application (sBLA) is based on the results of phase III IMpassion130 study, involving 902 patients with advanced breast cancer. The results demonstrated that Tecentriq plus nab-paclitaxel as an initial (first-line) treatment for unresectable locally advanced or metastatic TNBC increased the median progression-free survival (PFS) to 7.2 months instead of 5.0 months as compared to nab-paclitaxel alone group. In a subgroup analysis of PD-L1-positive population, the median survival was further increased to 7.5 months vs. 5.0 months.

The drug combination improved clinically meaningful overall survival in the PD-L1-positive population (25.0 months vs. 15.5 months). The safety profile of the drug combination was as per that reported for individual drugs. Currently, Genentech has seven ongoing phase III studies investigating Tecentriq in patients who are in various stages of TNBC.

The results of the study were presented at the European Society for Medical Oncology (ESMO) Congress and published in the October issue of New England Journal of Medicine.

“Tecentriq in combination with nab-paclitaxel has the potential to meaningfully advance treatment for people with PD-L1-positive, metastatic triple-negative breast cancer. People need more options for this type of breast cancer, which is particularly difficult to treat,” said Sandra Horning, M.D., chief medical officer and head of Global Product Development. “We are working closely with the FDA to bring this Tecentriq combination to people with PD-L1-positive, metastatic triple-negative breast cancer as soon as possible.”

It is expected that FDA will give its decision on approval by March 12, 2019. If approved, this will be the first cancer immunotherapy regimen for the treatment of PD-L1-positive, metastatic TNBC. 




Friday, November 16, 2018

Innovative combination of light and ultrasound could help catch ovarian malignancy early

A team of physicians and researchers from the Washington University School of Medicine in St. Louis has recently developed a ‘hopeful technique’ that combines ultrasound and photoacoustic technology to evaluate and diagnose malignant ovarian tumors at an early stage.

Ovarian malignancies are often diagnosed at a late stage because there are no specific signs and symptoms and no specific screening test for diagnosing ovarian cancer. Only 15% of ovarian cancers are detected at early stages.

The American Cancer Society estimates that about 22,240 women will receive a new diagnosis of ovarian cancer and about 14,070 women will die from ovarian cancer in the year 2018.

The researchers recently conducted a pilot study using co-registered photoacoustic tomography with ultrasound to evaluate ovarian masses in 16 patients at the School of Medicine and Barnes-Jewish Hospital. The results were recently published in the journal Radiology.

The team involving Quing Zhu, professor of biomedical engineering in the School of Engineering & Applied Science created a sheath using optical fibers that encases the standard transvaginal ultrasound probe. The optical fibers are connected with a laser source.

As the sheath is introduced in the vagina, the laser light penetrates the vaginal wall to get absorbed by the tumor to generate sound waves to reveal information about tumor vasculature and sO2 inside the ultrasound visible ovaries.

A normal ovary is not highly vascular and contains a lot of collagen tissue, but a malignant tissue is highly vascular because of neoangiogenesis. Using this multispectral photoacoustic imaging, the team looked at 26 ovarian masses from 16 participants that included nine invasive epithelial ovarian cancers (six serous carcinomas and three endometroid adenocarcinomas), three other tumors (two borderline serous tumors and one sex cord-stromal tumor), and 14 benign and normal (hereafter referred to as benign/normal) ovaries.

The researchers used two biomarkers to study the ovaries: relative total hemoglobin concentration (rHbT), which is directly dependent on the tumor angiogenesis, and mean oxygen saturation (sO2). The rHbT was almost two times higher for invasive epithelial cancerous ovaries as compared to normal ovaries P = .01) and the mean sO2 of invasive epithelial cancers, and the borderline and stromal tumors, was 8.2% lower than that of benign/normal ovaries (P = .003).

“Physicians are very excited about this because it might bring significant change into current clinical practice,” Zhu said. “It is very valuable to detect and diagnose ovarian cancers at early stages. It is also important to provide information and assurance to patients that there is no worry about their ovaries, instead of removing a patient’s ovaries. This technology can also be valuable to monitor high-risk patients who have increased risk of ovarian and breast cancers due to their genetic mutations. The current standard of care for these women is performing risk reduction surgeries to remove their ovaries at some point, which affects their quality of life and causes other health problems.”

Encouraged by the results of the pilot study, the team is gearing up to validate the findings in larger subjects and has applied for funding.

Here is a short video showing Dr. Zhu explaining the technology




Tuesday, November 13, 2018

Adaptive Vapor Ablation offers a safe, effective, and minimally invasive option for performing in-office endometrial ablation


AEGEA Medical, Inc., a privately held Silicon Valley company has developed a unique Adaptive Vapor Ablation technology for the in-office treatment of heavy menstrual bleeding. AEGEA Vapor System is unique because it does not require cervical dilatation, nor does the probe needs to reach the fundus like other conventional ablation systems.

Heavy menstrual bleeding (HMB) is a common entity nearly affecting 25% of the premenopausal female population and negatively impacts on the physical, emotional and social quality of life. 

Endometrial ablation became a popular non-surgical alternative for treatment of HMB with the advent of hysteroscopically guided techniques. Several devices that involve the delivery of heat, cold, radiofrequency, and microwave energy are in use for endometrial ablation, each with its limitation and downside.

AEGEA Vapor System harnesses the ability of water vapor to effectively reach every part of the endometrial cavity and ablate the endometrial lining. It is the only FDA approved device with the patented Smart Seal and IntegrityPro technology.

The slender, soft tip disposable vapor probe is gently inserted in the uterine cavity without the need for cervical dilatation. The cervical color of the probe holds it securely in place. The SmartSeal technology allows for real-time monitoring of the uterine and cervical seal while the IntegrityPro technology performs patented secondary safety check to ensure correct placement of the device. It is only after the secondary safety check that vapor is initiated. 

The total procedure time is 4 minutes with 2 minutes of vapor treatment, eliminating the need of any balloon, ice or other arrays. The vapor ablation can safely be performed in patients with a prior lower transverse cesarean scar, a particular type of fibroids and in the presence of Essure. It can also treat uterine cavities that are wider and up to 12 cm in length as opposed to conventional devices that can only treat cavities up to 10 cm length.



Recently, results of the 12-month prospective, multicenter, pivotal study of its AEGEA Vapor System™ were published in the peer-reviewed Journal of Minimally Invasive Gynecology. Conducted across 15 sites in the United States, Canada, Mexico, and the Netherlands, the prospective trial involved 155 perimenopausal women aged 30 to 50 years with heavy menstrual bleeding who received 120-sec vapor ablation to treat HMB.

At the end of 12 months study period, 90% of women had bleeding reduced by ≥50 percent and 99% reported an improvement in the quality of life. Additionally, 85% reported an improvement in physical intimacy after the treatment. No serious device or procedure related side effects reported.

AEGEA Vapor System also allows post-ablation uterine cavity access as shown by 11 patient data from the Pilot study. “This issue has never been addressed before and gives the vapor system a distinct advantage of the possibility of future uterine-related interventions,” said Maria Sainz, president, and CEO of AEGEA Medical in a press release.

AEGEA Medical, Inc. has announced the commencement of the Post-Ablation Cavity Access (PACE II) clinical study in women who previously underwent endometrial ablation as part of AEGEA’s pivotal trial of the company’s patented Adaptive Vapor Ablation technology. The multi-center observational study, which is being conducted at seven sites across the U.S. in up to 50 women, is designed to assess uterine cavity access as well as the feasibility of diagnostic and therapeutic interventions three to four years following treatment.

Here is an animation video about AEGEA Vapor Ablation procedure:




Monday, November 12, 2018

Be antibiotic aware during the antibiotic awareness week

World antibiotic awareness week is observed each November to increase global awareness about antibiotic resistance and unnecessary use of antibiotics among physicians, public and policymakers. This year the launch day is November 12 and various campaign and activities are planned globally to make the healthcare professionals and consumers aware of antimicrobial resistance (AMR.) 

AMR is an ever-rising menace and an urgent threat to public health. Antibiotic-resistant bacteria cause nearly one in five infections in developed countries. At least, 23,000 people die as a result of antibiotic resistance and nearly 2 million people get infected with antibiotic-resistant bacteria in the US alone.

If nothing is done, it is estimated that by 2050, more people will die because of bacterial infections that are resistant to available antibiotics as compared to cancer deaths. Besides promoting research and stricter prescribing laws, encouraging positive behavioral change to reduce the misuse of antibiotics remains one of the priorities in mitigating the spread of antibiotic resistance bacteria.

WHO has gathered information from 65 countries to track and document the consumption pattern of antibiotics around the world. The report notes that amoxicillin and amoxicillin/clavulanic acid – first or second-line treatments for common infections – are the most frequently used antibiotics worldwide.

Here are some of the key CDC messages for healthcare professionals to bring down the development of antibiotic resistance:

Always follow the clinical guidelines and remember the three “rights” for the antibiotic prescription–right antibiotic in the right dose for the right duration.

Shorten the antibiotic therapy to minimum effective duration to maximize the patient benefits and minimizing the side effects and development of resistance.

Protect your patient by only prescribing antibiotics when needed.

Educate your patients about the side effects and harms of antibiotic, their ineffectiveness in viral infection, what to do to feel better and when to contact your physician if they are not feeling good.

Make the patients and their caregiver aware of the signs and symptoms of sepsis.

Practice hand-hygiene at the clinics and hospitals to reduce cross infections.

If the patient is admitted, review the antibiotic regimen 48 to 72 hours after it is started based on the patient’s/resident’s clinical condition and microbiology culture results, and stop or change antibiotic orders as needed—a critical step in care.

Know about antibiotic resistance patterns in your practice areas and use the latest data to make informed prescribing decisions.

Friday, November 9, 2018

Elagolix shows promising results in the treatment of heavy menstrual bleeding associated with uterine fibroids


Oral elagolix either alone or with add-back therapy significantly reduces menstrual blood loss in 90% of pre-menopausal women with uterine fibroids reports the results of a new clinical trial published in November issue of Journal Obstetrics & Gynecology.

Elagolix is an oral gonadotropin-releasing hormone receptor antagonist and recently won FDA approval as the first and only oral drug for the management of severe pain associated with endometriosis.

This interventional, double-blind, randomized Phase 2b Study was conducted across five countries to evaluate the safety and efficacy of elagolix. Over a period of nearly 2.5 years, researchers enrolled 571 premenopausal women suffering from heavy menstrual blood loss and an ultrasound documented uterine fibroids.

These women were randomized to cohorts 1 (259) and 2 (308) and received 300 mg twice daily and 600 mg daily elgolix respectively. Each cohort has four arms: placebo, elagolix alone, elagolix with 0.5 mg estradiol/0.1 norethindrone acetate, and elagolix with 1.0 mg estradiol/0.5 mg norethindrone acetate.

The primary outcome measure was the percentage of women with a Menstrual Blood Loss (MBL) volume of < 80 mL at the last 28 days of the treatment cycle and a ≥ 50% Reduction in MBL volume from baseline to the final month.  The primary safety concern was the change in bone mineral density.

The average age of the participant was 43±5 years, and 70% were black.  Women in both cohorts demonstrated a significant reduction in menstrual blood loss and reached the primary endpoint in all three arms (all P<.001 vs. placebo). 

Elagolix arm showed a significant decrease in lumbar spine bone mineral density as compared to placebo, but add-on therapy with 1.0 mg estradiol/0.5 mg norethindrone acetate stopped the bone loss.

Dr. Bruce Carr, Professor of Obstetrics and Gynecology at UT Southwestern Medical Center and lead author on the study said the oral therapy offers new hope for patients suffering from menorrhagia with uterine fibroids for whom hysterectomy or myomectomy was the gold standard treatment. 

 “There are no orally approved drugs to decrease bleeding and prevent anemia in women with these tumors. Now, there is a medical option for this devastating disease that affects up to 75 percent of women,” he further added in a new release by UT Southwestern Medical Center.

A phase 3 ELARIS UF-EXTEND study of elagolix has also shown parallel results as the phase 2b trial and ELARIS UF-I and ELARIS UF-II phase 3 studies. AbbVie plans to include the ELARIS UF-EXTEND data as part of a submission for regulatory approval of elagolix for the treatment of uterine fibroids in 2019.



Thursday, November 8, 2018

Four things hospitals can adapt to reduce Maternal Mortality

The USA has the highest maternal mortality rates in all the developed countries around the world. Black women are 3 to 4 times more likely to succumb to pregnancy or childbirth-related causes of deaths as compared to their white counterparts.

The Center for Disease Control identifies three significant potentially preventable complications of pregnancy and labor that contribute a lion share to rising the maternal deaths. The causes include postpartum hemorrhage, severe hypertension, and venous thromboembolism.

Drs. Hollier & Brown, co-authors of a new perspective published in the New England Journal of Medicine (NEJM), identifies 4 actions that can be quickly adopted by all hospitals and healthcare providers to address the preventable causes of maternal deaths.

This picture by NEJM enumerates the four causes.



Abstract 

Wednesday, November 7, 2018

CDC video series: How to make HPV Vaccine recommendation to your patients?

CDC encourages healthcare practitioners, partner organizations, and other state programs to create awareness in the community about HPV virus, different pathologies caused by the virus and its mode of transmission. CDC also promotes adolescent’s HPV vaccination programs and provides guidance on achieving high HPV vaccination rates.

Healthcare providers are often faced with the dilemmas about initiating the conversation with parents and adolescents about HPV vaccination. This short informative video offers simple and practical guidance to have a successful conversation with parents about the vaccine.

Higher levels of Omega-3 fatty acids derived from seafood linked to healthy aging

Higher serum levels of circulating omega 3 polyunsaturated fatty acid (n3-PUFA) are linked to increased survival without chronic diseases and cognitive and physical dysfunction reports the results of a new study published online October 17 in BMJ.

Fish-oil and long-chain omega-3 fatty acids (EPA, DPA, and DHA) are well known for their role in human well-being. As evident through many previous studies, omega-3 fatty acids are involved in maintaining cardiovascular health, but their role in overall healthy aging is not well established.

This study is unique because unlike previous studies, the researchers from Tuft’s University did not solely rely on dietary history but serially measured the levels of biomarkers in blood. Long chain omega-3s in human diets are primarily derived from seafood, fish oil supplements, and foods fortified with fish oils while the shorter-chain omega-3s, like α-linolenic acid (ALA), are predominantly sourced from plants.

Adults with higher levels of n3-PUFA derived from seafood {eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA)} was associated with an 18% lower risk of unhealthy aging because of lower incidence of chronic diseases that include cardiovascular diseases, chronic kidney disease, lung disease, and cancer.

Surprisingly, α-linolenic acid from plants did not offer the same protection against healthy aging as those derived from seafood (hazard ratio 0.92, 95% confidence interval 0.83 to 1.02).

The study participants were sampled from a pool of 5888 adults enrolled in the Cardiovascular Health Study across 4 centers in the US. CHS is a population-based, longitudinal study to identify the risk factors related to the onset of coronary heart disease and stroke in US adults aged 65 years and older.

The researchers recruited 2622 healthy adults at baseline with a mean age 75 years and measured plasma phospholipid n3-PUFAs at three-time points over a 13-year period (1992/93, 1998/99, and 2005/06) to account for trends over time. Researchers measured cumulative levels of plasma phospholipid n-3 PUFAs using gas chromatography and expressed it as a percentage of total fatty acids.

Sociodemographic information gathered included age, gender, ethnicity, education, and income. Risk factors measured at each visit include dietary habits and intake, alcohol intake, body mass index, physical activity (excluding chores), blood pressure, lipids, lipid-lowering drugs, and smoking status.
 Participants were also asked about self-perceived general health, family history of myocardial infarction or stroke, hypertension, osteoporosis, depression, and arthritis.

Only 10% of the study population was non-white, and the majority (64%) were women. Those with higher blood levels of long-chain n-3 PUFAs were more likely to be female, well educated, from higher income group and leading a healthier lifestyle in general and consumed an additional serving of fish as compared to those with lower levels.

At the start of the study, n-3 PUFA levels were comparable between healthy agers and unhealthy agers. During 21 803 person-years of follow-up, 2330 (89%) participants did not age well, and 292 (11%) experienced healthy aging (positive deviance).

After taking into account the various demographic, medical and lifestyle confounders, participants with the highest long-chain n-3 PUFA levels were associated with 18% lower likelihood of unhealthy aging, as compared to those with lower levels.

When the researchers analyzed for individual n-3 PUFA, they found that individuals in the highest EPA or DPA groups had 24% and 18% lower risk of unhealthy aging as compared to those in the lower group. This protection was not provided by plant-based α-linolenic acid or docosahexaenoic acid (DHA).

In linear regression models, higher levels of long-chain n3-PUFAs, but not α-linolenic acid, were consistently associated with a lower likelihood of unhealthy aging.

Yeyi Zhu, Ph.D., MS, research scientist, Division of Research, Kaiser Permanente Northern California, and assistant adjunct professor, Department of Epidemiology & Biostatistics, University of California, San Francisco noted in an accompanying editorial “fresh evidence provides clues to healthier, not just longer lives.”

However, these results come with a caveat that no conclusion about the amount of food or the role of omega-3 fatty acid supplementation can be made from the study analysis. The authors only studied the blood levels of omega-3s from seafood and found that higher levels increase the chances of living a healthy life.

An epidemiological association does not prove causality, but this study encourages further research in the role of plausible biological mechanisms and interventions related to n3-PUFAs for the maintenance of healthy aging.

According to an estimate, 28 million life-years are lost annually from ill health, disability, or early death due to inadequate omega-3 intake worldwide. In the United States (US), LC omega-3 deficiency is ranked among the top-ten preventable causes of all-cause death.

Monday, November 5, 2018

Is the womb sterile in uncomplicated pregnancies?


Recent studies have challenged the century-old notion that the human fetal environment is sterile and that the neonate's microbiome is acquired during and after birth. A recent study published in the Journal of Science Translational Medicine reported the presence of unique commensal placental microbiome from the Firmicutes, Tenericutes, Proteobacteria, Bacteroidetes, and Fusobacteria phyla.

Research has shown that seeding of healthy microbiome at birth is crucial for human health in later life. Another study published in September issue of American Journal of Obstetrics and Gynecology does not support the existence of microbiomes within the healthy fetal milieu, and this concept of ‘sterile womb’ have implications in the development of practices like ‘vaginal seeding’ after cesarean births.

The researchers from Norway and Sweden randomly sampled amniotic fluid from study cohort of uncomplicated pregnancies at term from 1 of the three sites included in the Preventing Atopic Dermatitis and Allergies in children (PreventADALL) study. The amniotic fluid from 65 pregnancies was collected under sterile conditions, ten samples were from women undergoing elective, planned cesarean section and 14 were from women who had prior rupture of membranes.

Women with ruptured membranes have more than 10-fold higher concentration of prokaryotic DNA (16S rRNA) gene copies/mL. More than 50% samples of amniotic fluid from ruptured membranes cohort showed bacterial growth in anaerobic cultures, while all samples from women who had intact membranes were sterile.

The bacteria identified on culture were vaginal commensals and/ or intrauterine pathogens including Streptococcus agalactiae, Peptoniphilus harei/ asaccharolyticus, Lactobacillus reuteri/crispatus/vaginalis, and Prevotella amnii/bivia.

The authors concluded that in uncomplicated pregnancies, fetal development occurs in a sterile environment and fetal microbiome is seeded following rupture of membranes. Understanding the timing of the first microbial colonization in fetus could help the researchers in a better understanding of the origin of many diseases.


Friday, November 2, 2018

GE Healthcare new fetalHQ software streamlines evaluation of congenital heart diseases


The ultrasonologist can now assess the size, shape, and function of the fetal heart in less than 3 minutes with the GE Healthcare new fetalHQ software. Evaluating fetal heart and ruling out congenital heart anomalies is complicated at 18-20 weeks. This condition is not uncommon and affects one out of every 110 babies around the world.

At this gestational age, the fetal heart is exceptionally complex, just the size of a grape and the rate is near twice the adult heart rate. GE new tool – fetalHQ runs on GE Healthcare’s Voluson ultrasound systems and is the first tool to simultaneously examine the size, shape, and function of the fetal heart.

fetalHQ is the brainchild of Greggory DeVore, M.D., a specialist in maternal-fetal medicine at Huntington Hospital, Pasadena, California. He got inspired to develop the software from another software that used speckle tracking analysis to map the motion of tissues in the heart. This software was regularly used by adult and pediatric cardiologist to assess the function of the heart.

Dr. DeVore installed the software and reprogrammed it to visualize the fetal heart in 24 segments and map it in a way that was never done earlier.

“This was the genesis of the creativity behind using this software,” DeVore said. “From this, we made several measurements of the heart’s size, shape, and contractility – or how it’s squeezing. We immediately got to work and published 13 peer-reviewed articles that described the clinical value of this software.”

Here is a video showing the fetalHQ‘s automatic delineation of the fetal heart’s shape




Thursday, November 1, 2018

myLotus becomes the first and only quantitative fertility tracking home test to get clearance in Europe


Concepta Plc, a company based in Bedfordshire, UK, announced the approval of its breakthrough product, myLotus® in Europe. myLotus assists women to conceive naturally by quantitatively measuring the LH surge to pinpoint the day of ovulation. 

myLotus is scheduled to be launched this weekend at The Fertility Show in Olympia, London on November 3-4. The system consists of myLotus fertility monitor, ovulation test strips and pregnancy test strips and myLotus fertility App.

The woman must dip the ovulation strip into the urine sample and insert it into the fertility monitor. The monitor provides a “+” and “–” fertility test result and measures the levels of Luteinising Hormone (LH) present in your urine. This quantitative estimation of LH  makes it different from traditional (qualitative) ovulation tests. Women can continue to test throughout the menstrual cycle to know about the pattern of LH levels and surge.

The pregnancy test provided allows for easy testing for conception in the days following LH surge results.

The LH test results can be entered in the App and viewed in graphic form to know more about the fertile time for intimacy. The results are as accurate as the laboratory-based test without the hassle of leaving your home. Data can be shared with your healthcare provider to improve your chance of conception.

Matthew Walls, Chairman said: "The Fertility Show marks the UK launch of our myLotus® fertility product and the start of our roll-out across CE territories. Women attending the show can exclusively buy a Starter Pack, consisting of a myLotus® monitor, three packs of 20 Ovulation Tests (LH) and three packs of 3 Pregnancy Tests (hCG), at the 'Special Launch' price of £199. We look forward to an exciting Fertility Show and to welcoming women and couples to our stand.
Here is a simple animation video to know more about myLotus


Here is a video to know about how the fertility monitor works