Tag Archives: Health & Medicine

Latin American’s science contribution against COVID-19

A developing country’s greatest fear is to be the last in line for vaccination during a pandemic — and this has happened before. African countries know it too well: when H5N1 hit in 2004 and later H1N1 in 2009, they were among the last to receive vaccines. The most developed countries made sure they could get large amounts that were later stored despite the promise of donation. Vaccine nationalism affects us all, and yet we’re seeing signs of it happening all over again.

Latin American scientists are battling this fear since the start of COVID-19. During the pandemic, students volunteered to produce safe equipment for the health care workers in their country, but scientists knew they needed to do more. Despite challenges faced, Latin American scientists made strong contributions that are beneficial not only their own countries but also to their neighbors.

Uruguay

Making Latin America very proud, Uruguay is the country with the smallest number of cases, less than 2000 cases and less than 500 deaths. This is thanks to an efficient universal health care early action, and active communication. In an article in the British Medical Journal, Uruguay was praised as “having a lid” on COVID-19.

“Uruguay continues to provide hope” for the region, says Marcos Espinal, the head of the Communicable Diseases and Health Analysis department at the Pan American Health Organisation (PAHO). The country’s response could offer various lessons to the region and the world,” the BMJ article noted.

But despite being one of the most developed countries in the area and having such a solid response, Uruguay also showed how easy it is to lose control of the virus, with cases in early 2021 surging to unprecedented levels.

Uruguay was also involved in research throughout the pandemic. In the earlier stages, WHO recommended a more conservative method to diagnose SARS-CoV-2, but scientists from Universidad de la República and Institut Pasteur de Montevideo decided to develop a direct and cheaper method to test the disease and deploy large-scale testing. It is called a quantitative Polymerase Chain Reaction(qPCR)

Their idea became reality and soon they prepared tests that are used in the country to detect COVID-19. In weeks, Uruguay had kits to test its population with the help of a lab network between public hospitals and the academia, around 1000 tests a day. This level of efficiency made one of the researchers involved, Gonzalo Moratorio, become one of Nature’s 10. This also turned out to be one of the key methods through which Uruguay kept the virus in check for the better part of a year.

Instituto Pasteur de Montevideo.

That’s not all: the Uruguayan $13 kits received funding from Mercosur (Southern Common Market) in order to produce more kits to distribute in other countries. However, Uruguay was also quick to deploy another measure to help contain the virus: closing off most of its borders to international travel.

ProductionFurther information
KCOVID-19 RT-PCR Real TM Fast – kits for diagnosisInstitut Pasteur and Universidad de la República – UruguayJournal of virological methods
Oxford-AstraZeneca vaccineLiomont Laboratory (Mexico) and mAbxience(Argentina)mAbxience
Oxford-AstraZeneca vaccineFiocruz – BrazilFiocruz
CoronaVacInstituto Butantan – BrazilIntituto Butantan
Production of vaccines and tests

Mexico

Mexico was the first Latin American country to start vaccination with Pfizer-BioNTech. They have recently approved Sputinik V and plan to use the single dose Convidencia, a vaccine developed in China by the CanSino Biologics, which recently showed 67% efficacy.

In terms of production, with the help of Argentina, the country is planning to produce AstraZeneca vaccines to distribute to Latin America at affordable prices. The partnership is made between two companies: the Argentinean mAbxience, and the Liomont Laboratory in Mexico; mAbxience provides the active ingredient for the production which makes the vaccine even more accessible for Argentina.

Mexico suffered greatly as 2020 was the year the world lost Mario Molina, Nobel Prize laureate in chemistry for the discovery of effects of CFCs in ozone-depleting during his postdoctoral research. This work influenced the United Nations to create the Montreal Protocol. Despite being a professor at University of California San Diego, his advocacy towards making face masks mandatory was wall-known by Mexican citizens.

Months before his death he was involved in a study to understand the transmission of SARS-CoV-2 through aerosols. It stated the transmissions could be highly reduced using face masks. The problem was there were serious flaws in the publication, some epidemiologists even asked for the removal of the publication. The methodology did not give enough credit to social distancing restrictions and lacked a more sophisticated statistical analysis. We now know the importance of face masks thanks to more cautious research, some similar analysis even cite the study.

Brazil

In Brazil, the pandemic struck harshly. In part because of the socioeconomic conditions, but also due to questionable leadership. It became the country with the second-highest number of cases, as president Bolsonaro asked the country to “stop being sissies.” But important scientific information about the transmission and immunity to COVID-19 emerged from Brazil.

The second worst country facing COVID-19 situation has received hope recently. Two vaccines are being used now for emergency use, CoronaVac and AstraZeneca. The vaccination started in January with the CoronaVac, its arrival was so celebrated there is even a popular song for it.

The Sinovac Biotech’s CoronaVac is going to be produced in the country by the supervision of Instituto Butantan in São Paulo. The vaccine has 50,38% global efficacy, but more importantly 100% efficacy against moderate and severe cases, a major help for a country in the verge of collapsing its health care system. Alongside CoronaVac, the other vaccine that will be produced in Brazil is the Oxford-AstraZeneca the cheapest around the world. The Brazilian will produce it with the help of Fundação Oswaldo (Fiocruz) in Rio de Janeiro.

A group made of only Brazilian scientists from Fiocruz, Instituto Vital Brazil, and the Universidade Federal do Rio de Janeiro are also developing a serum to treat SARS-CoV-2 patients. It uses antibodies from horses, more specifically a glycoprotein, a technique usually used by Vital Brazil to produce hyperimmune serums. What the scientists do is inject the virus in the horses, who don’t get sick, so they produce the antibodies. It is estimated that 80 horses can produce enough plasma for 10,000 ampoules ofthe serum. The team is waiting for the approval of the beginning of the trials by Anvisa (Brazilian Health Regulatory Agency).

Cuba

The Caribbean country enjoys a lot of fame for its medical prowess and its diplomatic mission of sending doctors across the globe — the pandemic didn’t change that. Cuban doctors arrived in 40 different countries during the pandemic.

Cuba has had around 150 deaths and less than 12,000 cases. Now the race is on to vaccinate its population, with 4 studies being held in the country, the Cuban government plans to start vaccination during the first quarter of the year.

Soberana 2, developed by the Instituto Finlay de Vacunas, is the most promising vaccine they have right now. The phase 3 tests will be held with the help of Iran. The vaccine is a promising safe immunizer for infants and the elderly, it has part of the virus protein and is mixed with the tetanus vaccine. Another two vaccines in development are Abdala and Soberana 1 (also from a Finlay study) are still in phase 2.

But the interesting one is Mambisa which is delivered through a nasal spray, people who suffer from needle phobia may be glad to hear about this. Mambisa, which is in phase 1, uses part of the receptor-binding domain protein from coronavirus and a stimulus for the immune system using a protein from hepatitis B.

Argentina

The same technique used for the Brazilian serum was already approved by the ANMAT (Argentinian Health Regulatory Agency). It reduced mortality in 45% of patients experiencing the severe stages of the disease. The serum was developed by the biotech company Inmunova. It started being administered in January, a more advanced pace compared to other countries also trying the same method such as Brazil.

The therapy was developed by using the recombinant receptor-binding domain (RBD) of the virus to stimulate antibody production in mice and horses. Whereas the Brazilian study uses a different antigen, the trimeric spike (S) glycoprotein.

In the meantime, the Argentinian government didn’t stray away from Russia’s Sputnik V vaccine and decided to import it in December. The doubts towards Sputnik did not scare ANMAT, so they accepted it under emergency use. Well, now we actually have some confirmation so that’s excellent news for Argentina, although Argentina may not receive all the vaccines it expects for a while.

TypeResearch center Phase trialsPublication/
Further infromation
Hyperimmune
equine serum
therapy Inmunova
Argentina
approvedCONICET
Hyperimmune
equine serum
therapyVital Brazil,
Fiocruz, and
UFRJ
Brazil
to begin
phase 1
bioRxiv
Soberana 1 vaccineInstituto Finlay
de Vacunas
Cuba
phase 1 and
phase 2
RPCEC
Soberana 2 vaccineInstituto Finlay
de Vacunas
Cuba
phase 2RPCEC
Abdala vaccineInstituto Finlay
de Vacunas
Cuba
phase 2RPCEC
Mambisa vaccineInstituto Finlay
de Vacunas
Cuba
phase 1RPCEC
Therapies and vaccines being developed in Latin America.

Much like global heating, the ongoing pandemic is a challenge that requires both global and local solutions. It’s not just the most developed countries that can make a difference in the middle of a crisis, and even less so when facing science denial. Hopeful news like that shown here should be celebrated and serve as motivation for developing countries, without fueling selfish nationalistic policies that will make things even worse for everyone.

Smallest-yet image sensor for medical use wins Guinness World Record

A new, diminutive optical sensor has won a place in the Guinness Book of World Records for being so, so small (and still functional).

The newly-developed camera.
Image credits OmniVision.

OmniVision, a California-based developer of advanced digital imaging solutions has announced the development of its OV6948 image sensor — a piece of gear that now holds the record for the smallest image sensor in the world.

Eagle-eyed, but small

The sensor will be used in a camera module, which the company has christened CameraCubeChip. OmniVision’s announcement (published on their website) of the new device all but earmarks it for medical use, stating that it’s meant to “address the market demand for decreased invasiveness and deeper anatomical access”. In the future, the company hopes to also expand the range of potential users to include veterinarians, dental practitioners, and the health industry at large.

And it’s easy to see why. The new sensor measures just 0.575 x 0.575 mm (1 mm = 0.03 in), while the wafer-shaped CameraCubeChip is only slightly larger: 0.65 x 0.65 x 1.158 mm, roughly the size of a grain of sand. Because of its very small size, the sensor and camera module can be fixed to disposable endoscopes and used to imagine the smallest parts of the body, from nerves and parts of the eye to the spine, heart, the inside of joints, or the urological system. Patients are bound to appreciate how small the devices are, considering that alternatives available today are uncomfortable, and can become quite painful.

The camera will also be much cooler (in terms of temperature) than traditional probes, which means it can be used for longer inside a patient’s body without posing any risk. This is due to its very modest power usage: just 25 mW (milliwatts) of power.

The new sensor has a 120-degree field of vision, a focus range of 3 to 30 mm, allows for 200 x 200 resolution, and can process video at 30 fps (frames per second). It will also be able to transmit data in analog form over a maximum distance of 4 meters.

Another important advantage of the new sensor is that it can be affixed to disposable endoscopes. Patient cross-contamination caused by endoscope reuse is a growing public health concern, one which the camera can help fix, or at least reduce.

Trio wins Nobel Medicine Prize for uncovering how cells sense and adapt to oxygen levels

William Kaelin, Gregg Semenza (US), and Peter Ratcliffe (UK) jointly received the Nobel Medicine Prize for their work on how cells gauge and respond to oxygen availability, knowledge which could point the way towards new cancer treatments.

Together, the three identified the molecular mechanisms that regulate genetic activity in response to changes in oxygen levels inside the body — a mechanism that can be co-opted to fight a host of conditions.

Putting the O in operational

“[The team] established the basis for our understanding of how oxygen levels affect cellular metabolism and physiological function,” the jury said, adding that their research has “paved the way for promising new strategies to fight anaemia, cancer and many other diseases.”

There is a sizeable interest in academia and the pharmaceutical industry to develop compounds that can activate, block, or alter the oxygen-sensing mechanisms in living cells.

Oxygen is vital to animal cells, which use the gas to extract energy from food via oxidation. However, oxygen availability can fluctuate quite wildly for different tissues at different times, and when it’s in short supply, cells need to adapt. The jury awarded the Nobel Prize to the trio in recognition of the potential of their findings going forward, for both academia and industry.

“This prize is for three physician scientists who found the molecular switch that regulates how our cells adapt when oxygen levels drop,” Randall Johnson of the Nobel Assembly told reporters.

Kaelin, 61, works at the Howard Hughes Medical Institute in the US. Semenza, 63, is the director of the Vascular Research Program at the John Hopkins Institute for Cell Engineering. Ratcliffe, 65, is the director of clinical research at the Francis Crick Institute in London, and director of the Target Discovery Institute in Oxford.

The 2019 Nobel session is shaping up to be quite an exciting one — after a scandal postponed the awarding of last year’s literature prize, we’re set for two laureates in that category this year. The Peace Prize, to be awarded this Friday in Oslo, is also likely to spark public debate (hopefully, civil), as it has been speculated that Swedish teenage activist Greta Thunberg could receive it for her campaign against climate change (which has been quite polarizing so far). Other strong contenders are the Ethiopian Prime Minister Abiy Ahmed, who signed a peace deal with Eritrea, ending two decades of conflict, and NGOs such as Reporters without Borders and the Committee to Protect Journalists.

Doctors use CRISPR technique for the first time to treat genetic disorder

A group of doctors in the United States has used the powerful gene-editing technique CRISPR to try and treat a patient suffering from a serious genetic disorder. It will take months or even years before knowing whether the treatment is safe and how well it might be helping patients, but doctors are optimistic.

Credit: Flickr

 

CRISPR stands for Clustered Regularly Interspaced Short Palindromic Repeats. The term is used to refer to the various systems that can be programmed to target specific stretches of genetic code and to edit DNA and RNA at precise locations, as well as for other purposes, such as for new diagnostic tools.

“It is just amazing how far things have come,” says Victoria Gray, who received the treatment for sickle cell disease. “I always had hoped that something will come along. It’s a good time to get healed.”

Now, researchers have used CRISPR to try and treat a disorder called sickle cell disease.

Sickle cell affects millions of people around the world, causing bone marrow to produce a defective protein that makes blood cells that are sickle-shaped. The deformed cells get stuck inside blood vessels and don’t carry oxygen normally, causing a host of debilitating and, often, eventually life-shortening complications.

“It’s horrible,” Gray said. “When you can’t walk or lift up a spoon to feed yourself, it gets really hard.”

Doctors used cells taken from patients’ own bone marrow that have been genetically modified with CRISPR to make them produce a protein that is usually only made by fetuses and by babies for a short time following birth. Now, the hope is that the protein will compensate for the defective protein that causes sickle cell disease.

“It’s exciting to see that we might be on the cusp of highly effective therapy for patients with sickle cell,” says Dr. David Altshuler, chief scientific officer at Vertex Pharmaceuticals, which conducted the study.

Gray was diagnosed with sickle cell disease when she was an infant. One major symptom is agonizing, debilitating pain. Like many sickle cell patients, her symptoms have prevented her from living a full life. She couldn’t play like other children, was afraid to travel and had to give up her dreams of becoming a doctor or a nurse.

The defective blood cells also increase the risk of infections and damage to vital organs such as the heart. They also can cause life-threatening strokes. Many people with sickle cell disease don’t live past their 40s. Gray’s heart has already suffered damage.

CRISPR enables scientists to make very precise changes in DNA, raising hopes it will lead to new ways to prevent and treat many diseases. Doctors have already started using it to try to treat cancer, mostly in China. At least two patients in the U.S. have been treated for cancer.

Later this year, doctors in Boston are planning to use CRISPR to edit cells in patients’ retinas, in hopes of restoring vision in patients with an inherited form of blindness. But there are challenges ahead.

Frangoul acknowledged there are always risks with experimental treatments. But he says the research will go very slowly and carefully with close review by the Food and Drug Administration and other advisory panels.

“We are very cautious about how we do this trial in a very systematic way to monitor the patients carefully for any complications related to the therapy,” he said.

Medicinal plants used in the Civil War can stomp our modern antibiotic-resistant germs

New research into old germ-fighting methods suggests they could prove effective in combating antibiotic-resistant bacteria today.

abraham-lincoln-statue

Bronze statue of Abraham Lincoln in Virginia, USA.
Image credits Dennis Larsen

At the height of the Civil War, the paper reports, the Confederate Surgeon General released a guide of traditional plant remedies from the South that battlefield physicians could draw upon when faced with shortages of conventional medicine. Three of the plants in this guide — white oak (Quercus alba), tulip poplar (Liriodendron tulipifera), and devil’s walking stick (Aralia spinosa) — have antiseptic properties that could be useful today, the authors explain.

The seeds of salvation

“Our findings suggest that the use of these topical therapies may have saved some limbs, and maybe even lives, during the Civil War,” says Cassandra Quave, senior author of the paper and assistant professor at Emory’s Center for the Study of Human Health and the School of Medicine’s Department of Dermatology.

The team found that extracts from these three plants have significant antimicrobial properties in the face of three dangerous species of multi-drug-resistant bacteria: Acinetobacter baumannii, Staphylococcus aureus, and Klebsiella pneumoniae. These bacteria are often seen in wound-associated infections.

Quave’s research focuses on understanding the role of plants in traditional healing and other practices, a field known as ethnobotany.

“Ethnobotany is essentially the science of survival—how people get by when limited to what’s available in their immediate environment,” she says. “The Civil War guide to plant remedies is a great example of that.”

“Our research might one day benefit modern wound care, if we can identify which compounds are responsible for the antimicrobial activity,” adds Micah Dettweiler, the first author of the paper.

If the active ingredients in these plants are identified, explains co-author Daniel Zurawski from the Wound Infections Department at the Walter Reed Army Institute of Research, they can be tested through modern “models of bacterial infection.” In a way, he says, this is mixing the “wisdom of our ancestors” with modern techniques to create new solutions for the problems we’re facing today.

Around 1 in 13 soldiers that lived through the Civil War went back home with missing limbs, the authors report. “Far more Civil War soldiers died from disease than in battle,” Zurawski explains, adding that he was surprised to see how “common amputation was as a medical treatment for an infected wound.” At the time, germ theory was still crude, and very much a work-in-progress. The training medical personnel at the time received was also shoddy at best.

An antiseptic was simply defined as a tonic used to prevent “mortification of the flesh.” Iodine and bromine were sometimes used to treat infections, according to the National Museum of Civil War Medicine, although the reason for their effectiveness was unknown. Other conventional medicines available at the time included quinine for treating malaria, and morphine and chloroform to block pain.

Union blockade

The Confederacy, however, didn’t have reliable access to these compounds. In the 1863 copy of “Resources of the Southern Fields and Forests,” Francis Peyre Porcher (who was commissioned by the Confederacy for this task) set about detailing alternatives to the essential but lacking medicine. Porcher was a botanist and surgeon from South Carolina, and his book represents a compilation of medicinal plants of the Southern states, including plant remedies used by Native Americans and enslaved Africans. Among others, the book contains a description of 37 species for treating gangrene and other infections. His work formed the foundation upon which Samuel Moore, the Confederate Surgeon General, produced the “Standard supply table of the indigenous remedies for field service and the sick in general hospitals.”

The team collected samples of the three plants from around their university’s campus, abiding to the specifications Porcher set out in his book. Extracts were produced from white oak bark and galls; tulip poplar leaves, root inner bark and branch bark; and the devil’s walking stick leaves, and were then tested on multi-drug-resistant bacteria commonly found in wound infections.

White oak and tulip poplar extracts inhibited the growth of S. aureus, while the white oak extracts also inhibited the growth of A. baumannii and K. pneumoniae, the team writes. Extracts from both of these plants also inhibited S. aureus from forming biofilms, which can insulate it against antibiotics.

Staphylococcus aureus is considered the most dangerous of the staph bacteria, and can spread from skin infections or medical devices to infect internal organs. Klebsiella pneumoniae is a leading cause of hospital infection and can result in life-threatening cases of pneumonia and septic shock. Aceinetobacter baumannii is particularly worrisome as it exhibits extensive resistance to most first-line antibiotics, and is closely associated with combat wounds. Extracts from the devil’s walking stick inhibited both biofilm formation and quorum sensing — a signaling system that staph bacteria use to manufacture toxins — in S. aureus.

“There are many more ways to help cure infections, and we need to focus on them in the era of drug-resistant bacteria,” says Quave.

“Plants have a great wealth of chemical diversity, which is one more reason to protect natural environments,” Dettweiler adds.

The paper “American Civil War plant medicines inhibit growth, biofilm formation, and quorum sensing by multidrug-resistant bacteria” has been published in the journal Nature Scientific Reports.

The National Academies of Sciences, Engineering, and Medicine launches website about vaccine facts

The work of the National Academies spurs progress by connecting understandings of science, engineering, and medicine to advising national policies and practice. The studies they do have lasting impacts, from guiding NASA’s agenda for space exploration, to charting the course for improving the quality of health care, to proposing effective strategies to guard against cyber attacks. When faced with a complex question, the National Academies bring together experts from across disciplines to look at the evidence with fresh eyes and openness to insights from other fields.

To counter misinformation and pseudoscience about vaccines that is fueling measles outbreaks in the United States and other countries, the National Academies last week launched a website that provides clear, concise, and evidence-based information on the most frequently asked vaccine safety questions.

In a joint statement, the three National Academies presidents said the evidence base includes a number of the group’s studies that examined vaccine access, safety, scheduling, and possible side effects.

“Our work has validated that the science is clear—vaccines are extremely safe,” they said. The presidents are Marcia McNutt, PhD, with the National Academy of Sciences, C.D. Mote, Jr, PhD, with the National Academy of Engineering, and Victor Dzau, MD, with the National Academy of Medicine.

“Given our shared congressional mandate to advise the nation, we are compelled to draw attention to these facts in order to inform better decision-making at a time when it is urgently needed to protect the health of communities in our country and around the world. We call on our professional colleagues everywhere to share these facts as widely as possible.” they wrote.

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research.

The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering.

The National Academy of Medicine (formerly called the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health.

Academy members are among the world’s most distinguished scientists, engineers, physicians, and researchers; more than 300 members are Nobel laureates. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions.

Xiaoyi.

A Chinese AI passed the national medical licensing exam, so technically it’s a doctor

A robot named Xiaoyi just passed the written stage of China’s national medical licensing examination, the first stepping stone for any would-be practitioner in the country. It’s the first time a robot has passed this or any comparable exam.

Xiaoyi.

Smart or not that head is just creepy, though.
Image via China Daily.

The first time Xiaoyi (meaning Little Doctor) ever tried his hand at the exam, during a practice run, its results were less than stellar — barely scoring 100 out of the maximum 600. Since then, it’s pored over dozens of medical textbooks, more than 2 million medical records, and 400,000 articles in a bid to learn how to ‘doctor’. Xiaoyi took the real test in August and, according to the results released earlier this month, pulled off a stunning 456 points — 96 points above a passing grade.

Artificial medicine

It’s the first time an artificial intelligence passes this exam, and it did so in only a fraction of the allowed time, says iFlyTek, the company that developed the entity along with Tsinghua University.

Wu Ji, deputy director of Tsinghua’s electrical engineering department, says that their AI couldn’t learn the same way a human student does, for example. The read-memorize style of learning, or rote learning, wouldn’t cut it for a machine taking the test because “since 2013, more than half of the questions in the test are about [patient] cases,” Wu explained, “so it’s impossible to purely rely on memorizing and searches.”

Instead, they’ve instilled the robot with the ability to link words, sentences, even whole paragraphs together and give it a certain ability to reason. Xiaoyi’s developers worked with medical professionals while writing the robot’s code, drawing on their clinical and diagnostic expertise to tweak the robot’s algorithms.

This ability to interpret and to form connections between pieces of data, rather than merely storing and retrieving them, powered Xiaoyi’s impressive results on the digital version of the exam, which was overseen by the National Medical Examination Centre. Wu believes the machine’s score is a testament to its ability to learn, reason, and make judgments by itself. I’d take that with a grain of salt right now, however; we’ve programmed very smart machines, most exceeding the capability of a human’s in certain aspects before, and yes they do learn and form connections but in a very limited sense of the word.

Still, Xiaoyi is undeniably an amazing piece of technology, and it has made a spectacular debut with this result. It’s a ways off from working independently to diagnose people, Wu adds, but that doesn’t mean the AI won’t find its way to practitioners’ offices.

“Rather than replacing doctors, AI is able to help doctors better serve patients. By studying the medical cases and diagnosis skills of top doctors in top hospitals in megacities in China, our doctor AI can serve as an assistant to help doctors in remote areas in the country,”  Wu said.

Xiaoyi can automatically capture and analyze patient information and help with initial diagnosis, and unlike other medical-inclined AIs out there, like IBM’s cancer-fighting Watson, the little doctor isn’t specialized in a single field. All very good news, especially so in China, a country that’s experiencing a significant shortage of medical personnel in rural areas.

“We will officially launch the robot in March 2018,” saif Liu Qingfeng, chairman of iFlytek. “It is not meant to replace doctors. Instead, it is to promote better people-machine cooperation so as to boost efficiency.”

On Wednesday, iFlyTek became a member of the AI alliance, set up by the Chinese Academy of Sciences, which aims to promote the research of basic sciences and the application of the cutting-edge technology. Its future plans include setting up a 1.02 billion yuan ($150 million USD) fund to support software and hardware developers, which will go towards startups that have core technologies but lack business know-how, or companies that excel in commercializing products but are unable to integrate AI into their devices.

ReefMad Splash.

Continued Reefer Madness, 80 years later

ReefMad Splash.

Image credits Joshua Livingston / Flickr.

In the life sciences field, craving for knowledge and passionate dreams of bettering the lives of those inflicted with disease fuel assiduous exploration. Research and discovery can even become profoundly spiritual when advancing scientific research. Viewed through the lens of a Judeo-Christian faith background, the process of drug discovery and development can become a unique way to participate in an ongoing creation story.

But new discoveries can prompt a more destructive impulse, too. An almost obsessive desire to keep knowledge from others, or to blind them with junk “science,” is too common among those who wish to twist public agendas. In 1937, for example, a paucity of knowledge about the cannabis plant led to oversimplifications at best, and at worst, outright falsehoods. Unfortunately, misinformation and deceit remain rampant in the cannabis industry, as we know it, today – despite significant changes in state regulatory frameworks and federal enforcement priorities related to cannabis, that open access to cannabis-derived therapeutics.

Ignorance fuelled cannabis prohibition 80 years ago, when President Roosevelt signed the “Marihuana Tax Act”, instituting a prohibitive federal tax on cannabis-related activities and leading, essentially, to the criminalization of activities related to possession, production, and sale of cannabis. It came on the heels of the 1936 propaganda film Reefer Madness, which showcased alleged negative consequences of “marihuana” use by high school students — including manslaughter, suicide, attempted rape, and hallucinations. In testimony during legislative hearings on the Marihuana Tax Act, Federal Bureau of Narcotics Director Harry Anslinger famously testified: “This drug is entirely the monster Hyde, the harmful effect of which cannot be measured.”

The Devil's Weed.

His views defined the US’ take on “weed”. This poster for the 1949 film She Shoulda Said No! promotes the picture as “Exposing the Tragic Truth of the Marihuana Menace!”
Image via Hygienic Productions / Public Domain.

At the time, we might well have asked: to what “drug” was Anslinger referring? The cannabis plant itself? For, at the time, the structure of only one phytocannabinoid sourced from the cannabis plant had been elucidated: Cannabinol (CBN). The structures of more prominent compounds, such as Tetrahydrocannabinol, (THC, which ironically, is more highly psychoactive than CBN) and Cannabidiol (CBD), would not be elucidated until 25 years later. Was CBN deserving of the “monster Hyde” moniker used by Anslinger?

Given what we now know about the important role played by novel, whole plant medicine for patients who do not respond well to other pharmaceutical therapies, the answer is “no.” Plants bred to unlock the symphonic, therapeutic value of rare non-psychotropic cannabinoids, sesquiterpenes and monoterpenes, reflect dreams coming true for patients, and are nothing like the apocryphal nightmare Anslinger evoked.

In the 1930s, without the reliable analysis of cannabinoid and terpenoid profiles made possible today by mass spectrometry, the prohibitionist agenda was fueled by speculation and ignorance. This lack of knowledge paved the way for “Marihuana” [sic] to be specifically included in a list of identified “hallucinogenic substances” in the 1970 Controlled Substances Act. Considering what we know and are able to cultivate today, including, but not limited to, novel type II plants bred for targeted therapeutic value and reduced adverse effects, or Type III plants that are non-THC dominant, it is intellectually impossible to generically label “marihuana” [sic], which is defined as “all parts of the plant Cannabis sativa L.” as a drug, per se, or as a hallucinogenic substance.

If it should not be called a drug, what should it be called?

Cannabis is best described as a phytochemical factory with biosynthetic routes to produce metabolites with significant and varied pharmacologic impact on the human endocannabinoid system (ECS). Many targets have been explored in recent years for modulation of ECS activity to address significant unmet therapeutic needs. The polypharmacological approaches made available for the diverse phytochemicals that can be found in cannabis dovetail nicely with the remarkably broad statement by NIH researchers that modulating endocannabinoid system activity “may have therapeutic potential in almost all diseases affecting humans.”

There are dramatic differences, however, between different types of cannabis “phytochemical factories.” These complex plants produce a wide range of distinct compounds: 540 chemical entities, of which more than 60 are cannabinoid compounds with diverse therapeutic properties and mechanisms of action – including some that counteract each other. For example: the varied pharmacologic properties of type I vs type III plants, type II plants with THC:CBD ratios of 1:2 vs 2:1, plants that are myrcene dominant vs beta caryophylene dominant, just to name a few, reject unequivocally, by their very existence, the notion that cannabis is a single, de facto drug.

Leafly poster.

A poster by Leafly to illustrate the sheer number of different cannabis strains out there.
Image credits torbakhopper / Flickr.

To give another example, the opium poppy plant (Papavar somniferum) has been used medicinally for over five millennia and produces different alkaloids with therapeutic uses, among them morphine and codeine. Mistakenly filling a prescription for one with the other would be a serious problem; they are not interchangeable. We don’t refer to the “medical opium poppy” when discussing treatments for pain – instead, we refer to the distinct compounds the plant produces. Cannabis is a phytochemical factory, not a drug, and without this framework, the ignorance of 1937 will continue, to the detriment of both patients and physicians.

We have learned a tremendous amount in the last two decades about the receptors and ligands that comprise the ECS and the role played by our bodies’ endogenous cannabinoids in facilitating inter-cellular communication. This has spawned development of new synthetic and semi-synthetic cannabinoids that target specific ECS functions, as well as sophisticated breeding programs that have yielded new plants producing various novel combinations and concentrations of phytocannabinoids.

All of this means a new, less deceitful and more informative vocabulary must be used when discussing herbal cannabis and crafting laws and regulations governing its production, distribution and use. But who should bear responsibility for changing the paradigm and discourse around cannabis and medicine? All of us – through our different roles in research, publication, commercialization, legislation, prescription, cultivation and responsible consumption of cannabinoid-based medical treatments targeting the ECS. Knowledge that is widely dispersed and understood by all players in the marketplace, from lawmakers, to regulators, to physicians and consumers, is the only way to prevent misinformation.

For example, sativa and indica are words without objective meaning and should be shelved in favor of data generated from validated assays used to measure cannabinoid and terpenoid profiles. The sooner the marketplace understands that the chemical profiles of cannabis plants are not correlated with leaf size or other aspects of plant morphology, the sooner all will gain a better appreciation for how far the cannabis currently available to us has come and how great its potential is.

In addition, public safety concerns related to cannabis should not be ignored or rejected as attempts to advance a prohibitionist agenda. Rather, these concerns should be addressed directly in user education and regulation drafting, by applying knowledge from research laboratories, clinician offices, and study centers around the globe.

Recognizing the potential harms of chronic, high-THC cannabis use is a critical first step that must be followed by acknowledging evidence that adverse effects may be mitigated with product selection decisions. The Transform Drug Policy Foundation, a UK-based organization focused on ending drug prohibition, has long highlighted the importance of safer THC:CBD ratios in recommendations for regulations, yet, this information is hardly propagated in the US. And, information about seeking alternative terpene profiles to mitigate undesirable sedative effects of certain cannabis products – something daytime school-going, or working, cannabis users will surely appreciate – should not be confined to the pages of scientific journals.

In the case of cannabis phytochemical factories and cannabinoids in general, knowledge means protection. Periodic review of the latest published and peer-reviewed research is the best, and perhaps only, way to avoid being duped by modern day reefer madness.


This op-ed was authored by Gary Hiller, President and COO of Phytecs.

How technology is revolutionizing medicine

Medicine has come a long way in the past century, and we have technology to thank for much of it.

When we look at the last decades, we can see major improvements that almost seemed to happen overnight — but nothing happens overnight in medicine. Drug development and clinical trials can take years or decades, but because technology is moving so fast, medicine has been able to take significant leaps, sometimes at dramatic speeds.

Let’s have a look at just a few of the improvements brought by such developments.

Restoring movement in paralyzed patients

What started out as a sci-fi dream turns into reality more and more — several labs and research institutes across the world are making breakthroughs in restoring movement to paralyzed patients. For instance, in 2016, 24-year-old Ian Burkhart, who lost the ability to move or feel from the shoulder down in a diving accident, recovered movement in his arm, enough to pour water from a bottle into a jar and even play some Guitar Hero. Previously, in 2014, researchers had helped paraplegic patients regain some control over their legs, and brain-computer interfaces that allow paralyzed people to “type” with brain power alone were also developed.

We’re still a ways away from making these widely available treatments, but the mere fact that scientists can tackle things like paralysis, which were once thought to be a final sentence, shows how far science has gone.

Bionic eyes

There are several different types of visual prostheses—also known as bionic eyes—being developed around the world. While this technology can only restore partial vision and not full vision, this multidisciplinary approach truly seems unbelievable.

For instance, Steve Myers, a 63-year-old Iowa man will be able to see after decades of being in the dark.

“The implant consists of 60 electrodes,” Myers said. “It’s got a short cabling on it; then it has the receiver, which is about like two nickels stacked together and impregnated (with) a silicone rubber and implanted into the white of the eye.”

Getting Treated Online

Of course, this is no substitute for a real doctor, just a way to communicate with him or her.

Some medical practices now offer the ability to “see” a doctor on their website. More often than not, you leave a message on the website about what you are experiencing. A doctor reviews it and can discuss your options. While online STD testing may still be a ways away, in other cases, a lot of time, effort, and energy can be saved this way. Imagine having a urinary tract infection and your doctor easily calls in a UTI prescription at your local pharmacy. The idea is that you save a lot of time and so does the doctor — it’s a win-win situation. Of course, not all illnesses can be handled online. Serious problems always require a trip to the doctor, but for an advice or a discussion about a well-known condition, this could work out efficiently.

The Cure for HIV

Did we ever think we would truly get there? Well, we have finally seen someone cured of HIV! A child, that was infected at birth, went through 40 weeks of rigorous treatment. At 9 years old he was tested and while HIV was still found in his system, they are incapable of reproducing. If he chooses to have his own children later in life, this means he could very well not transfer the disease on to his offspring.

What the study showed was that with early treatment in those infected at birth, we could slow the progress of the disease. Education about safe sex will still be vital, especially in countries in which HIV runs rampant. This is still an impressive advancement we have made in the fight against HIV.

A sponge-filled syringe

Image via US Army.

This might not seem like a much at first, but a simple sponge-filled syringe could save numerous lives by preventing blood loss. The mechanic process is extremely simple: the sponges absorb blood, they swell up and cling to the wound, ensuring that they stay in place. Enough pressure is applied that the bleeding is temporarily stopped, giving enough time for the patient to reach a medical facility.

It can be extremely useful in war zones or in the ER.

3D Printing

At a first glance, 3D printing and medicine can have very little in common, but the two have started to entwine staggeringly fast. Cheap 3D printed prostheses are already a reality, as is biomedical printing. Tumor and cell models are also developing fast, and the fact that it’s all so cheap and fast makes the technology even more attractive for future research.

Diabetes Takes Another Hit

The year of 2016 proved to be one where diabetes took some big hits. One item, called the artificial pancreas or MiniMed670G, checks blood sugar around every 5 minutes. A needle slipped under the skin checks glucose levels and a pump worn over the abdomen administers insulin as needed. This reduces instances of hypoglycemia and improves the life of the diabetic. Additionally, Lexicon Pharmaceuticals have an inhibitor called sotagliflozin that is working wonders and is now in phase 3 trial. Not only is it able to control glucose levels in the kidneys and intestines, it’s also assisting in weight loss and lowering systolic blood pressure in diabetic patients. Both of those are often needed in conjunction with maintaining healthy glucose levels.

There are a ton more medical breakthroughs happening in recent years and we suspect that we will keep seeing more and more in the coming years as our technology continues to grow at a rapid pace. We are certainly seeing improved quality of life with many of these breakthroughs and we couldn’t be more excited!

 

 

Medicine.

The CDC warns that “chronic Lyme” is bogus and the treatments are horrifying and deadly

With summer upon us in earnest, ticks are popping up all over the place. Even so, a growing trend has physicians more preoccupied than the risk of contracting Lyme disease — last Friday, a report published by the CDC warns people about the slew of bogus treatments marketed for the condition.

Medicine.

Image credits Andrea Ajale.

It’s a dark day indeed when the CDC has to protect people from dishonest treatments rather than diseases — but that’s exactly what the center had to do last Friday. Writing in the CDC’s Morbidity and Mortality Weekly Report, a group of doctors from all over the country, including members from the University of Colorado, the CDC, Yale University, Stanford, and the University of California, San Francisco warn that alternative medical treatments for “chronic Lyme disease” are all unproven and very likely harmful — some even deadly.

These doctors recount the experience of five patients who, erroneously or intentionally diagnosed with what’s essentially a made-up condition with no scientific backing, suffered through and from such treatments which in some cases cost them their lives.

Fake Lymes

Now, Lyme disease is a real, well-documented, pretty nasty disease. It’s caused by an infection with Borrelia burgdorferi, a spirochete which uses blacklegged ticks as a vector. Initial symptoms include the appearance of a characteristic “bull’s eye” rash on the skin, fever, headache, and fatigue. If untreated, the infection spreads out through the body causing arthritis, heart inflammation, dysfunctionalities of the nervous system, even brain swelling.

Patients may develop an (actual and recognized) condition called Post-Treatment Lyme Disease Syndrome / PTLDS. Such patients will show lingering symptoms after being cured of Lyme’s, and, while it’s exact cause is unknown researchers suspect it comes down to lingering tissue damage and the way out immune system responds to them — not an infection, and not something which can be cured by antibiotics.

So it’s easy to see why nobody would be thrilled of contacting it. Luckily, its symptoms make Lyme disease pretty easy to spot and two to four weeks of antibiotic treatments usually flushes the spirochetes out of your system.

But capitalizing on that fear are people who advocate for chronic Lyme disease or, as I like to call it, male Bos taurus feces. It’s a wide-net grouping of vague, nondescript symptoms, ranging from fatigue and generalized pain to neurological disorders. Most times, the diagnostic is pinned without performing any FDA-approved lab testing, often without any lab testing at all, for that matter. In fact, it’s not uncommon for the patient to be told he’s suffering from chronic Lyme despite negative lab results for a B. burgdorferi infection. Because what’s a bit of evidence worth in the face of your pseudo-scientific conviction and/or willingness to con people out of money?

Take this pill daily — for years

Blacklegged Tick.

This is what a blacklegged (deer) tick looks like.
Image credits Fairfax County / Flickr.

Many patients, who are confused by their symptoms often fall for these treatments out of sheer desperation to find a cure to their suffering. Self-described “Lyme-literate” doctors, a term which isn’t indicative of any kind of training (if you hear your doctor say this it only means he’s particularly qualified to be replaced,) convince these patients they’re the victims of a chronic infection and put them on these “alternative” treatments.

What followed was exactly what you’d expect to happen when somebody treats you for something you don’t have in a way that doesn’t work — years of pointless suffering, avoidable infections, even death.

“Patients and their health care providers need to be aware of the risks associated with treatments for chronic Lyme disease,” the doctors declare.

Here’s a short recount of what the five patients mentioned by the authors went through.

[panel style=”panel-danger” title=”Fake Lyme, fake treatment, real pain.” footer=””]

One woman in her 30s showed fatigue and joint pain. She was given several rounds of oral antibiotics, and her condition got worse. She was then administered IV antibiotics for several weeks following which she developed a severe catheter-associated blood infection. She ultimately died of septic shock.

Another woman, in her 50s, who had been diagnosed with Lou Gehrig’s disease (amyotrophic lateral sclerosis, or ALS), also got a second diagnosis — chronic Lyme. She was prescribed a course of herbal remedies, and when these somehow, miraculously failed to cure the made-up disease, was put on IV antibiotics for seven months. This mammoth dose of drugs wrecked her intestinal flora and she developed C. difficile colitis, an intractable intestinal infection linked with antibiotic use. After two years battling the infection, she succumbed to ALS-associated complications.

One teenager suffering from headaches and back pain was diagnosed with chronic Lyme and put on a few months of oral antibiotics, followed by five months of IV antibiotics. She developed a severe blood infection as result of the treatment and suffered septic shock. She needed several weeks’ care in the ICU to recover.

A woman in her late 40s was put on several rounds of oral and IV antibiotics to treat her fatigue and cognitive difficulties two years after being treated for Lyme’s. She ultimately developed an infection which spread to her spine, destroying her 9th and 10th thoracic vertebrae.

The final patient, a woman in her 60s with an autoimmune disease, mixed connective tissue disease, and degenerative arthritis, was diagnosed with chronic Lyme and took more than 10 years of alternative therapies. During this time she overcame several catheter-associated blood infections, which eventually caused abscesses to form in her spine that required surgery.

[/panel]
Regardless of whether you think you may suffer from PTLDS or “chronic Lyme”, you should avoid these alternative treatments at all costs, the CDC report reads. And there’s a lot of them out there. While the most widely-prescribed treatment are prolonged courses of antibiotics, in 2015 internet-listed therapies for Lyme disease and chronic Lyme ranged from simple herbal and vitamin supplements to $13,000 “photon” therapy, heat and magnet therapies, treatments to remove heavy metals such as mercury, bismuth treatments (potentially fatal), or infusions of hydrogen peroxide. That’s not all! The more exotic treatments included bee venom-based remedies, drinking a bleach solution, your own urine, or a coffee and herbal enema.

Delicious.

As you’ve seen earlier, antibiotics can cause a lot of harm. Their overuse destroys beneficial microbe communities in the body, power-level drug-resistant bugs in your body, and increase the chance of you getting a life-threatening, fully-resistant infection. But, since there’s such a bounty of these alternative treatments floating around, we can only imagine what the effects of some of them are — hint: definitely not good.

“These cases highlight the severity and scope of adverse effects that can be caused by the use of unproven treatments for chronic Lyme disease,” the authors conclude.

“In addition to the dangers associated with inappropriate antibiotic use, such as selection of antibiotic-resistant bacteria, these treatments can lead to injuries related to unnecessary procedures, bacteremia and resulting metastatic infection, venous thromboses, and missed opportunities to diagnose and treat the actual underlying cause of the patient’s symptoms.”

Red pill

Homeopathic products will be labeled as bogus unless there’s scientific proof that they work

Producers of homeopathic treatments must make proof of efficacy or specify on their product’s label that there is “no scientific evidence that the product works”, the Federal Trade Commission has decided.

Red pill

Image credits TheDigitalWay / Pixabay.

Homeopathy can trace its roots back to 1796 when Samuel Hahnemann developed the theory by studying the anti-malaria properties of cinchona. The bark was traditionally believed to fight the condition due to its astringency, and Hahnemann noted that other astringent drugs do not have any use against malaria. So he tested the bark on himself, by ingesting various quantities, and found that it induced malaria-like symptoms.

From this, he concluded that “like cures like”, as he considered that “that which can produce a set of symptoms in a healthy individual, can treat a sick individual who is manifesting a similar set of symptoms.” Further work on this theory led him to the conclusion that diluting certain substances under their point of toxicity would make these solutions cure the associated symptoms.

[ALSO READ] Everything you wanted to know about homeopathy but didn’t ask

We’ve had a lot to say over the years about just how wonderfully useless homeopathy is as a medical approach. And we’re not the only ones doing so — the practice is and has long been dismissed by any form of serious science discussion. Still, the US homeopathic remedy market is still going strong, with an estimated $3bn in sales in 2007.

Luckily, the US government has decided to step up and make it clear for customers that what they’re buying is smoke and mirrors. Homeopathic product manufacturers have to come up with proof of their products’ efficiency or clearly point out on labels that there is “no scientific evidence that the product works”.

“Homeopathy, which dates back to the late-eighteenth century, is based on the view that disease symptoms can be treated by minute doses of substances that produce similar symptoms when provided in larger doses to healthy people,” said a notice, filed earlier this month by the Federal Trade Commission.

“Many homeopathic products are diluted to such an extent that they no longer contain detectable levels of the initial substance. In general, homeopathic product claims are not based on modern scientific methods and are not accepted by modern medical experts, but homeopathy nevertheless has many adherents.”

The FTC said that a homeopathic drug claim that is not substantiated by competent and reliable scientific evidence “might not be deceptive if the advertisement or label where it appears effectively communicates that: 1) there is no scientific evidence that the product works; and 2) the product’s claims are based only on theories of homeopathy from the 1700s that are not accepted by most modern medical experts.”

First living-donor uterus transplant in the US performed in Texas

A Texas hospital has performed four uterus transplants from live donors, one of which was successful. This marks the first occasion such a procedure has been performed in the US.

Image credits Hey Paul Studios ? Flickr.

The four women underwent transplants in September. They all had a condition called Mayer-Rokitansky-Küster-Hauser syndrome, which caused them to be born without a uterus. So far, three of the organs had to be removed as they weren’t getting enough blood flow, and the doctors feared the possible complications which might have developed. The fourth patient is stable and the procedure seems to be doing well so far. A statement by BaylorScott&White, the hospital who performed the transplants, says that the surgical team was “cautiously optimistic” that the fourth uterus would be functional.

“This is the way we advance, from learning from our mistakes,” lead surgeon at Baylor University Medical Centre in Dallas, Giuliano Testa, told Time.

“I am not ashamed of being the one who will be remembered as the guy who did four [transplants] in the beginning and three failed. Even if through failure, I am going to make this work.”

The procedure is still experimental and there’s a high failure rate. More research and operations are needed before it’s deemed safe. Even if the surgery becomes widely available, it’s very likely it will take a huge financial toll on potential patients. But, for women born without a uterus or for those who’ve had it damaged or removed, undergoing such a transplant might be their only change at getting pregnant and having children. Here’s a basic run-down:

[panel style=”panel-success” title=”Here’s the basic rundown” footer=””]Surgeons take the uterus and part of the vagina from a donor, living or deceased.
This is then implanted in the patient. Surgeons connect the uterus to the body’s circulatory system, and attach it along the vagina and pelvis. No nerves need to be attached.
In case of a successful transplant, the patient should be able to safely get pregnant in about 6 to 12 months’ time. In virto fertilisation will be used (as the uterus is not connected to the ovaries).
The woman will have to deliver via a C-section.[/panel]

At this point, the doctors are sadly not sure if the fourth case will be a success or not.

UK doctors plan to perform the procedure using non-living donors in the near future, but for now, Sweden is the only country apart from the US where such transplants have succeeded. The nine procedures in Sweden used live donors — like the Texas ones — and some of the women went on to have children. The experts helped the TBaylor team during the operations.

 

The 2016 Nobel Prize in medicine goes to Yoshinori Ohsumi for his work on autophagy

The first of 2016’s Nobel Prize recipients has been decided: the award for medicine or physiology goes to Japanese biologists Yoshinori Ohsumi for his work in autophagy — the process by which cell components are recycled (from the Greek words for “self-eating”.)

Autophagy is the process by which cells break down their components to free building blocks for other uses. It plays a pivotal role in keeping our body healthy, and Professor Ohsumi’s work “led to a new paradigm in our understanding of how the cell recycles its content,” The Nobel Assembly at Stockholm’s Karolinska Institute said.

He analyzed thousands of strains of yeast and identified 15 genes that underpin this internal recycling process. There is a lot of interest in the biomedical field surrounding autophagy because any alterations to the process can promote diseases such as cancer, or can increase resistance to anti-cancer procedures.

The committee said that Professor Ohsumi’s work also linked faults in this process to Parkinson’s disease, type 2 diabetes, and a host of other disorders common in elderly patients.

“I was surprised. I was in my lab,” recalled professor Ohsumi of hearing about the decision.

The award is the 107th award in this category since the first Nobel Prizes were handed out in 1905. Last year’s prize was shared by three scientists who developed treatments for malaria and roundworm infections. The physics prize will be announced on Tuesday, chemistry on Wednesday and the Nobel Peace Prize on Friday. The economics and literature awards will the announced next week.

 

Celebrating life one awesome picture at a time: the Welcome Image Awards 2016

Medical research charity Welcome Trust has been bringing together some of the most spectacular images in biomedical research under their yearly Welcome Image Awards. They aim to “recognise the creators of the most informative, striking and technically excellent images that communicate significant aspects of biomedical science.” And the submissions certainly are all of those things — combing trough the entries of this 19-edition long contest, I can’t help but be slack-jawed in amazement at how beautiful life is.

This year is no different. Capturing images from the very tiny all the way to a heart as big as your head, the entries are a veritable celebration of life. So here are some highlights of this year’s winner’s gallery — sit back, and enjoy.

Our thanks to the Welcome Image Awards team for providing the pictures.

Cryogenic scanning electron micrograph of a single human stem cell. Image credits Sílvia A Ferreira, Cristina Lopo, Eileen Gentleman / King’s College London.

Cryogenic scanning electron micrograph of a single human stem cell. It’s roughly 0.015 mm.
Image credits Sílvia A Ferreira, Cristina Lopo, Eileen Gentleman / King’s College London.

Stem cells are yet undifferentiated cells that can divide to produce almost any cells found in the human body. This particular cell was harvested from the hip bone of a healthy patient, who donated bone marrow to help those experiencing complications after receiving a transplant.

The cell is resting in a chemical mixture that mimics its natural environment inside the body so that the team can observe how it behaves in-vivo. To take the shot, researchers flash-froze the sample, then put it under an electron microscope.

Also, it kind of looks like an exploding star doesn’t it?

Maize leaves. Image credits Fernán Federici / Pontificia Universidad Católica de Chile / University of Cambridge.

Maize (corn) leaves.
Image credits Fernán Federici / Pontificia Universidad Católica de Chile / University of Cambridge.

Maize is one of the most widely grown cereal crops in the world, but not many people have ever seen it like this. The image is approximately 250 micrometres (0.25 mm) wide. It’s up close enough that you can see each individual cell and their nucleus — the green rectangular shapes and orange circles. It was taken in collaboration with Jim Haseloff and OpenPlant Cambridge.

Human liver grafted into a mouse starts growing. Image credits Chelsea Fortin, Kelly Stevens and Sangeeta Bhatia / Koch Institute, © MIT

A small piece of human liver grafted into a mouse with a damaged liver.
Image credits Chelsea Fortin, Kelly Stevens and Sangeeta Bhatia / Koch Institute, © MIT.

Human liver cells (red/orange) and human blood vessels (green) in the new liver have grouped together and started to grow using blood (white) from the mouse to help. Development of blood vessels in organs like the liver has previously been very difficult, which has been a major barrier to scaling up small implants like these for medical use. The liver can regenerate itself but certain types of damage are irreversible, and there is a growing shortage of replacement organs.

Researchers hope that one day, implants like this could be used to repair livers damaged by liver disease, cirrhosis or cancer. The image is 1.1 mm wide.

Swallowtail butterfly. Image credits Daniel Saftner / Macroscopic Solutions.

Close-up shot of a swallowtail butterfly.
Image credits Daniel Saftner / Macroscopic Solutions.

Butterflies have two large compound eyes to see quick movements and a pair of antennae which pick up smells. The proboscis (their long feeding tube) is curled up like a spring here, but it unrolls so the butterfly can use it like a straw to drink nectar from flowers. Swallowtail butterflies are widely distributed around the world and are often found in wetlands such as marshes and fens. They get their name from their characteristic hindwing extensions, which are reminiscent of a swallow’s tail. This image is 5 mm wide.

Cow Heart. Image credits Michael Frank / Royal Veterinary College

Cow Heart.
Image credits Michael Frank / Royal Veterinary College

The heart was preserved in formalin in a Perspex container and was photographed in the Anatomy Museum of the Royal Veterinary College in London. It measures 27 cm from top to bottom and is roughly four times the size of a human heart.

Credit: Macroscopic Solutions. Wellcome Images

Moth scales.
Image credits Mark R Smith / Macroscopic Solutions.

Close-up shot of the scales on a Madagascan sunset moth (Chrysiridia rhipheus). This large colourful moth is most active during the day, unlike most other moths which are nocturnal. It is native to Madagascar and is often mistaken for a butterfly. As it flaps its wings during flight, they shimmer in the light and change colour, but these colours are an illusion. They come from light bouncing off the curved scales at different angles. The wings themselves hardly contain any colour pigment or dye. This image is 750 micrometres (0.75 mm) wide.

Cross section through an ebola virus. Image credits David S Goodsell / RCSB Protein Data Bank.

Cross section through an ebola virus.
Image credits David S Goodsell / RCSB Protein Data Bank.

Ebola was first discovered in mid-1970s Africa but has really found its way into the public’s attention following the tragic outbreaks we’ve seen a few years ago. It can cause severe illness and often proves fatal to the host. This watercolour and ink illustration takes a look inside an Ebola virus particle.

The pink/purple membrane surrounding it is stolen from an infected cell. The broccoli-like turquoise proteins on the membrane attach to the cells that the virus infects. A layer of proteins (blue) supports the membrane on the inside. Genetic information in the form of RNA (yellow) is stored in a cylinder called a nucleocapsid (green) in the centre of the virus. This whole virus is approximately 100 nanometres (0.0001 mm) wide, which is 200 times smaller than many of the cells that it infects.

This picture was selected as the overall winner of this year’s contest.

Clathrin cage. Image credits Maria Voigt / RCSB Protein Data Bank.

Clathrin cage.
Image credits Maria Voigt / RCSB Protein Data Bank.

These little babies are the cell’s forklifts — they’re cage-like structures made from the protein clathrin around small membrane sacs. They bring molecules into the cell and transport them from place to place as they’re being used. They’re also responsible for sorting through all the cargo, making sure each substance is taken where it’s needed. Certain toxins and germs can hijack these cages to attack cells.

When not carrying stuff or acting like unwilling trojan horses, the cages break up — each building block of the cage is a triskelion, a pattern of three bent legs (dark blue) joined together with three short rods (light blue.)

This digital illustration was created using scientific data about the sequence, shape, size and fit of these building blocks and how they assemble into cages. Cages can form in different sizes, usually less than 200 nanometres (0.0002 mm) across. This particular cage is approximately 50 nanometres (0.00005 mm) across.

 

 

2015 Nobel prize for Physiology or Medicine Awarded

This year’s Nobel Prize in Physiology or Medicine is split into three parts, being divided between William C. Campbell and Satoshi Ōmura — who jointly share a half “for their discoveries concerning a novel therapy against infections caused by roundworm parasites” — and Youyou Tu “for her discoveries concerning a novel therapy against Malaria.”

Image via wattsupwiththat

 

Alfred Nobel had an active interest in all areas of research, including medicine. In his will, he set for the Prize to be awarded each year for scientific excellence in five major fields of study: Physics, Chemistry, Physiology or Medicine, and Economic Sciences.

The Physiology and Medicine part of the Nobel prize is awardied by the Nobel Assembly at Karolinska Institutet in Stockholm, Sweden, for discovery of major importance in life science or medicine. Discoveries that have changed the scientific paradigm and are of great benefit for mankind are awarded the prize, whereas life time achievements or scientific leadership cannot be considered for the Nobel Prize.

A total of 327 scientists have been nominated for the 2015 Nobel Prize in Physiology or Medicine, among who 57 individuals were nominated for the first time. This year it was claimed by the guys studying the bugs, for research into the treatment of roundworm parasite infections and Malaria.

The winners of the Nobel Medicine prize 2015 (L-R) Irish-born William C Campbell, Satoshi Omura of Japan and China’s Youyou Tu. Photograph credits to: Jonathan Nackstrand

The winners of the Nobel Medicine prize 2015 (L-R) Irish-born William C Campbell, Satoshi Omura of Japan and China’s Youyou Tu.
Photograph credits to: Jonathan Nackstrand

 

William C. Campbell and Satoshi Ōmura discovered a new drug, Avermectin, the derivatives of which have radically lowered the incidence of River Blindness and Lymphatic Filariasis, as well as showing efficacy against an expanding number of other parasitic diseases. Youyou Tu discovered Artemisinin, a drug that has significantly reduced the mortality rates for patients suffering from Malaria.

Campbell’s and Ōmura’s Ivermectin is currently seeing use in all parts of the world that are plagued from parasitic diseases, invaluable for improving the wellbeing of millions of people with River Blindness and Lymphatic Filariasis, primarily in the poorest regions of the world. It’s so effective, in fact, that the diseases are on the verge of eradication, a major feat of medical history.

Artemisinin is used in all Malaria-ridden parts of the world, and with 200 million individuals who report infection with the disease each year, it’s seeing a lot of use. When used in combination therapy, it is estimated to reduce mortality from Malaria by more than 20% overall and by more than 30% in children. For Africa alone, this means that more than 100 000 lives are saved each year.

“The discoveries of Avermectin and Artemisinin have revolutionized therapy for patients suffering from devastating parasitic diseases. Campbell, Ōmura and Tu have transformed the treatment of parasitic diseases. The global impact of their discoveries and the resulting benefit to mankind are immeasurable,” Karolinska Institutet’s award decision reads.

 

 

First long term study on medical cannabis shows only small adverse effects, but also small reductions in pain

A new study conducted on the medical consumption of cannabis came up with some good news, and some bad news: for starters, while there were some adverse effects on consumers, no serious effects were reported. However, the reduction in pain also seems to be very small.

Image via Wiki Commons.

Dr. Mark Ware, Associate Professor in Family Medicine and Anesthesia at McGill University has conducted the first ever long term study on the effects of Medical Cannabis; he studied 216 individuals with chronic pain, and 215 controls (chronic pain but no current cannabis use) from seven clinics across Canada. Several randomized controlled trials of smoked cannabis have shown efficacy in chronic pain and spasticity, but these trials have been short (1-3 weeks of exposure) with small sample sizes (20-60 subjects).

“We conducted a prospective cohort study to describe safety issues among subjects with chronic noncancer pain. A standardized herbal cannabis product (12.5% THC) was dispensed to eligible subjects for a one-year period; controls were subjects with chronic pain from the same clinics who were not cannabis users. The primary outcome consisted of serious adverse events (SAEs) and non-serious adverse events (AEs).”

The study evaluated the safety of cannabis use by patients with chronic pain over one year. They found that there was a significant difference in the rate of non-serious adverse effects at a rate of 2.5g herbal cannabis per day. These non-serious disorders included nervous system disorders, respiratory disorders, infections and psychiatric disorders. Twenty-eight (13%) subjects in the cannabis group reported at least 1 SAE, compared with 42 (19%) in the control group.

The main non-serious affection was respiratory. The researchers write:

“We found 78 respiratory events in the cannabis group and 56 in the control group, and most were considered mild or moderate. No increase in risk of serious respiratory AE associated with medical cannabis use was detected. Medical cannabis users had a higher rate of developing non-serious respiratory AEs during one year of follow-up compared to controls. This is consistent with reports that long-term cannabis smoking is associated with an increased risk of chronic bronchitis.”

But on the other side, while the reduction in pain was statistically significant, it was significantly lower than expected – comparable to a placebo effect (a placebo mirror was not conducted).

Image credits: Ware et al, 2015.

It should be kept in mind that this doesn’t affect the debate on the recreational legalization of cannabis, but such a minor improvement in subjective pain estimates doesn’t really speak strongly about its pain-killing abilities.

Amazing 1930 map of “Herbal Cures”

LgMedicinalPlants

Slate just reported on this amazing map of ‘Herbal Cures’ from 1932 of the medicinal plants in common use among pharmacists and the public back then. The map itself states under the heading ‘The Service of Pharmacy’:

“It is important that the public does not lose sight of the fact that the professions of Pharmacy, Medicine, and Dentistry, each give an essential service, which must not be impaired or destroyed by commercial trends. The public and the professions whill suffer equally if these services are allowed to deteriorate. In pharmacy the public should understand something of the breadth of knowledge required of the pharmacist. Few people realize the extent to which plants and minerals enter into the practice of pharmacy, and how vital they are to the maintenance of the public health. It has been stated that upwards of 70 percent of all medicines employed are plant products.”

Amazingly, you will find Cannabis Sativa listed as a medicinal plant used on the Druggist’s map! Consider that in modern times this plant alone has been used to incarcerate hundreds of thousands of citizens simply for possessing, using and/or trading it as a commodity!

Everything you wanted to know about homeopathy but never asked

Last week we described a study which concluded that homeopathy is nothing more than a placebo effect — it was just one of the many scientific studies which found the same thing. But many people swear by homeopathy and, judging from what’s happening in the comment section and our inbox, they feel very strongly about it. So let’s take a step back, analyze what’s happening with homeopathy, and then we can all our own conclusions.

The mechanism behind homeopathy

Samuel Hahnemann, the originator of homeopathy, 1796. He believed that “Like cures like”, dilution increases potency, and diseases are caused by miasms.alleged predispositions to a particular disease.

Homeopathy is a system of alternative medicine proposed in 1796 by Samuel Hahnemann, based on his doctrine of “like cures like”. Essentially, the belief is that the same thing which makes you sick can be used to heal you. Hahnemann believed that all diseases are caused by miasms, and homeopathy can be used to eliminate them. Not familiar with the term? Probably because it’s long been disproven.

Truth be told, not all homeopaths today believe in the so-called miasm theory — but all homeopathy is based on like-cures-like — using “active substances” to address all sorts of problems.

These active substances are things which cause symptoms similar to that of a disease, in the belief that if the body recognizes the symptom, it will start to fight the real disease. But it has to be diluted — a lot.

Hahnemann has this idea that undiluted doses intensify the symptoms and exacerbate the condition, sometimes causing dangerous toxic reactions. He specified that the substances be diluted due to his belief that succussion activated the “vital energy” of the diluted substance and made it stronger.

So the proposed cures are prepared by dilution. You take the active substance (whatever that may be) and usually dilute it by putting one drop of it in 1 liter of alcohol or distilled water, and then you mix it. After the mixing, you take 1 drop of this newly obtained substance and put it in another fresh liter of alcohol or distilled water, rinsing and repeating the process many times, until well past the point where none of the original molecules remain. The more diluted the substance is, the more effective the “cure” will be. The idea is that the alcohol or distilled water will somehow “remember” the molecule and have an impact on your body. Right of the bat, this goes directly against basic science — not something a pharma company or another is saying but against well-established, basic medical (and chemical) science.

But wait, you’ll say, how can you be sure that there is no more molecule in the substance? Well, we’ll have to get a little familiar with Avogadro’s number. Avogardo was a brilliant chemist (not related to homeopathy in any way). He showed that for every mole (unit of substance) of a substance, there are 6.02214129(27)×1023 constituents (atoms or molecules). For example, in a mole of OH, there are 6.02214129(27)×1023 molecules of OH – and the same goes for every substance. Let’s not get into how he arrived at that conclusion as that’s a different discussion, but his number is one of the very foundations of modern chemistry.

homeopathy2

Via Popular Science.

So if you have a substance and you dilute it up to the point where its concentration starts to outweigh Avogadro’s number, you end up with no more molecules of the initial substance. Say, if you take a gram of a substance and you put it in a kilogram (1000 grams), the concentration will be 10-3. If you take a gram of the new substance and put it in another fresh kilogram, it will be 10-6 and so on. If you do this 8 times, you reach a concentration of 10-24, which outweighs Avogadro’s number — and that’s when you don’t have any more molecules of the initial substances. Homeopathy often goes way past that number, and there’s just nothing left in to have an effect — even if you assume that the method works.

But does the method really work?

What science says about homeopathy

There is little room for discussion or interpretation here — although there’s been no lack of trying. Study after study has tried to find evidence or even just a workable mechanism for homeopathy, but they’ve found the exact opposite. There’s no mechanism behind homeopathy, and there’s no effect past a placebo.

If this was the case, and water did have a “memory,” we would have to rewrite all of science as we know it. Even ignoring the centuries of scientific research disproving homeopathy, a simple thought experiment can show go a long way when it comes to the process.

Just imagine: in its history, water will have contacted literally millions of other substances, and by this thought process, it has a memory of all of them — so just drinking a glass of regular water should make you immune to a swarm of diseases, right? So then why even have homeopathy — water is naturally diluting all sorts of things, so we should kind of be immune to everything, right?

Lastly, even if there were any active substance, and even if water would have a memory, something that causes symptoms similar to the X disease doesn’t cure X disease. That’s just wishful thinking, and there is nothing to suggest that this works. The scientific consensus is pretty strong on this case. Here are just a few studies:

The list goes on and on.

So why does it seem to work?

OK, but by quoting some of the common responses, lots of people still stand by homeopathy. You often hear things like “This worked for me”, “It worked for millions of people”, and “How can you say it doesn’t work?” Well, here are some of the reasons why homeopathy may appear to work:

a) unassisted natural healing – Your body is awesome at self-healing. Some people are more resilient than others, but generally speaking, your body heals itself all the time. It can eliminate even strong diseases on its own.

b) the placebo effect – Simulated treatments are surprisingly effective in many cases. Combine this with your self-healing, and you get quite a powerful tool.

c) the consultation effect – Modern research has shown that if you just go to the doctor and receive a consultation, the care, concern, and reassurance a patient experiences when opening up to a compassionate caregiver (read: homeopath) can have a positive effect.

d) unrecognized treatments – An unrelated food, exercise, environmental agent, or treatment for a different ailment may have occurred. Maybe you drank a lot of green tea, or that trip to the ocean did wonders for your lungs.

e) regression towards the mean – Many diseases and conditions are cyclical — the symptoms get naturally stronger and weaker in time. Since patients tend to seek care when discomfort is greatest, it’s pretty likely that the symptoms will naturally get weaker.

f) cessation of unpleasant treatment – Many times, homeopaths recommend the ceasing of conventional treatments — this is extremely dangerous and should never be done without consulting an actual medical doctor. Oftentimes, the conventional treatment causes some unpleasant side effects, perhaps even more so than the disease’s symptoms. When you stop taking the treatment, the side effects may go away, but the disease remains and gets.

But even so, what harm can homeopathy actually do?

You may try to go for a win-win strategy, and take both conventional treatments and homeopathic treatments — what have you got to lose, right? Well, technically, nothing. Homeopathy doesn’t do anything bad because, well, it doesn’t really do anything!

The main problem is using only homeopathy as a treatment. This can be very dangerous, as has been shown numerous times; when homeopathy is used in place of real medicine, the risks are real. From Calgary, an avoidable child death has been linked to the use of homeopathy instead of medicine. In 2002, 1-year-old Isabella Denley was prescribed medications for her epilepsy. Instead of using them, her parents consulted an iridologist, an applied kinesiologist, a psychic and an osteopath. She was being treated purely with homeopathic medication when she died. The infant girl, Gloria Thomas, died of complications due to eczema which was treated only with homeopathy. Eczema! This is an easily manageable disease, and her parents were declared guilty of manslaughter — and rightfully so.  By the time she died, she was the weight of an average three-month-old, her body was covered with angry blotches and her once black hair had turned completely white.

These are not isolated cases. Using homeopathy instead of real treatment is dangerous, and you should not do it! If you are rejecting medicine and treating your child only with homeopathy, you’re putting him or her at risk. That’s the bottom line, and there’s no going around it. As Bad Astronomy’s Phil Plait puts it, it is “perhaps the most ridiculous of all ‘alternative’ medicines, since it clearly cannot workdoes not work, and has been tested repeatedly and shown to be useless.” Even though this relatively simple and highly manageable disease killed his daughter, Thomas Sam stood by his beliefs in homeopathy — don’t make the same mistake!

Spoiler alert: no, they are not.

I’d like to make a special mention of homeopathic vaccination — not receiving your (or your child’s) vaccines is especially dangerous, and, as with other treatments, homeopathic vaccinations don’t do anything.

A note on natural remedies

There is a lot of confusion with people mistaking homeopathy with naturopathic treatments. That’s a separate discussion, but for now, let’s just say that the two things are very different. Natural remedies (herbs, teas, plants, etc) are not homeopathy. You should always consult with your doctor or pharmacist before taking anything, and only follow treatments prescribed by an authorized physician.

3D Printed Bacteria Answers Questions

3D Printing for MEdicine

While 3D printing at the consumer level has mostly been a novelty, the applications in the medical community have been exceptionally exciting.

A certain type of 3D printer, where it would typically extrude plastic layer by layer to create a three-dimensional object, can now be used to extrude gelatin instead, creating breeding grounds for bacteria. It sounds like a John Carpenter movie just waiting to happen, but the implications are extremely exciting for those in the scientific world.

Scientists have been attempting for quite some time to understand the social nature of bacteria. While they are suspended in colonies, they are capable of communication between themselves, and even with members of other species. This communication – or sociability, if you will – is thought to be a driving force behind their ability to become resistant to antibiotics over time. In other words, bacteria seem remarkably able to compare notes and collaborate in order to survive.

The bacterial colonies created in the 3D printing process can take many shapes, including pyramids and spheres. This whole process is an attempt by scientists to answer longstanding questions about bacteria, such as how many of them have to be clustered together, and in what shape and size, to allow the colony to start behaving differently together than the cells would on their own.

As we alluded to above, there have been some extremely exciting advancements made possible by 3D printing, though very few of these have reached the public yet. Scientists from the University of Edinburgh have even created a printer that can replicate human embryonic stem cells. The possibilities are staggering.

The study of harmful bacteria looks to be every bit as promising. Scientists are now able to better understand biofilms – that is, the ability for bacteria to “cement” themselves together with a gluelike substance, which makes them more resistant to antibiotics or even the human immune system than they would be individually.

Particularly troubling are the biofilms that plague the lungs of those suffering from cystic fibrosis. To date, there has been a measure of success treating this condition with antibiotics, but there has so far not been a treatment that’s been successful at eradicating 100% of the offending bacterial biofilms. What this means is that the patient must endure a cycle of treatment and infection that is not only physically detrimental, but possibly deadly. Fully understanding harmful bacteria and their biofilms could prove critical in understanding cystic fibrosis and similar diseases, and in developing treatments that work decisively the very first time.  The same applies for drug addicts, and the ability to correct some of the biofilms that result from the chemical reactions of say Methamphetamine could reduce side effects as well as help addicts speed up their meth detox timeline.

The 3D printing procedure looks like something out of science fiction. The bacterial cells are added to a gelatin mixture, creating something that looks startlingly like a dessert. From there, researchers use a laser to carve around the suspended bacteria, linking the gelatin to the bacteria permanently, as well as creating pockets where the bacteria can breed freely.

After the bacterial colonies have matured, scientists can add various antibiotics, such as ampicillin, to study how the bacteria react to it. So far, the results have indicated that the bacterial resistance to antibiotics is largely dependent on colony structure as well as the presence of other pathogens in the colony.

As with any 3D printing technology, these procedures are hampered somewhat by the price of the equipment, but there is a great deal of optimism that the prices will come down in the near future. For now, there’s no question that the possibilities are exciting indeed while the scientists of the University of Texas responsible for this discovery work out the litigation rights for the future of it’s release.

India Among 15 Nations Tops in Child Pneumonia Deaths: IVAC Study

India Among 15 Nations Tops in Child Pneumonia Deaths: IVAC Study – Breastfeeding for six months, early diagnosis and medicine, effective health delivery and smoke-free cooking could prevent the deaths in developing countries Hyderabad ,Nov 21: India, an emerging economic superpower along with China in Asia, but with below 1 per cent of its GDP spending on public health, registers the highest number of child pneumonia deaths in the world.


Yet, it has not yet introduced the new generation anti-pneumonia vaccinations (PCV 10/PCV13) in its immunization programme along with China, Indonesia and Burkina Faso which also had competed with India in recording high pneumonia related deaths.

“As many as 3- 4 million child deaths could be prevented by accelerating use of pneumococcal vaccines in all developing countries over the next decade,” says A Pneumonia Progress Report-2011 released recently by the International Vaccine Access Centre(IVAC) under the John Hopkins Bloomberg School of Public Health(USA).

The report, based on a study of 15 developing countries with disturbing incidence of Pneumonia, had also suggested a 4-pronged strategy to augment the drive to save more children from the scourge.
1. Promoting exclusive breastfeeding of the kids during their first six months of life to boost immunity to infection;
2. Facilitating early detection of symptoms to administer appropriate anti-biotics on time;
3. Strengthening health delivery systems and care on routine basis; and
4. Limiting exposure to indoor smoke by increased use of smoke free stoves.
While the governments had been making all efforts to promote breast feeding through public spending, the early detection of Pneumonia, leave alone other diseases, has become increasingly difficult in the developing world, mostly due to illiteracy, negligence and lack of awareness even among the literates until the situation goes out of hand.
The rich could afford going to the costly corporate hospitals for treatment whereas the poor approach the mostly ill-equipped government hospitals at the eleventh hour, risking the life of the kids, resulting in increasing mortality.
Notably, Indian health minister Ghulam Nabi Azad had recently announced increase of the health budget to 2 – 3 per cent of the GDP during the 12th Five Year Plan (2012-17) keeping in mind the demand for the sector as a social welfare measure.
Another major problem, also admitted by the WHO, is use of smoke emitting traditional stoves for cooking that work on fossil fuel in a majority of the rural areas in the 15 countries studied by the IVAC.
Some regional governments in India,, like Andhra Pradesh, had introduced schemes to offer gas stoves and LPG connections free of cost or on subsidies to the poor. But it had become a major burden to the exchequer in the hydrocarbon controlled economies.
India recorded the highest 371,605 child pneumonia deaths in 2008 followed by Nigeria (177,212), Congo (112,655), Pakistan (84,210), Afghanistan (80,694) and China (62,229).
Yet, there was “no action” till date on the introduction of the new generation PCV10 and PCV13 Pneumococcal Vaccines in India, China, Indonesia and Burkina Faso into the national immunization program.
Only Congo, Ethiopia and Kenya had introduced the vaccines, Nigeria, Afghanistan and Bangladesh had applied while Pakistan, Angola, Niger, Uganda and Tanzania had approved.

“The speed at which PCV10 and PCV13 are being introduced in low-income countries is unprecedented and is expected to have tremendous health impacts. It is estimated that by 2013, 11 of the15 countries profiled will have introduced the pneumococcal vaccines into their national immunization programs,” the IVAC report says.

The study also noted that only 69 per cent of children with suspected pneumonia, on par with Pakistan, were hospitalized while 13 per cent got antibiotics and only 46 per cent got exclusive breast feeding in the first six months.
Ethiopia has registered the lowest 19 per cent of its children with pneumonia sent to a health facility as also 5 per cent getting antibiotics whereas their breastfeeding rate was 49 per cent, more than India.
Uganda topped the list of 15 nations under study with 60 per cent of their kids getting breastfed in the first six months. Niger recorded the lowest 10 per cent followed by Angola 10 per cent and Nigeria 13 per cent.
China however tops the list of countries with 99 per cent of children immunized for Pertusis as also Measles in 2010, followed by Angola (91, 93) and Burkina Faso(95,94) as against India(72,74) respectively.
Quoting WHO, the IVAC report said every year, pneumonia claims more than one million children before their fifth birthday – accounting for more young deaths than AIDS, Malaria and Tuberculosis combined. This loss of life is especially tragic because pneumonia is preventable and treatable.
The World Health Assembly in 2010 resolved that all countries should make the Global Action Plan for the Prevention and Control of Pneumonia (GAPP) of the WHO and UNICEF a national priority. The IVAC had been monitoring and reporting the progress of the implementation of the interventions to combat pneumonia.
While the report noted steady increase in coverage of vaccines against Pertusis (17 per cent) and Measles (21 per cent) since the year 2000 among the 15 focus countries including India and China as against the target of 90 per cent reach, it regretted that four of these countries have yet to introduce HiB vaccine against deadly Influenza in the 20 years since its introduction.
By introducing PCV vaccines in low-income countries, faster than HiB vaccine, 158 million additional children in these countries get protected over the next decade, with hectic efforts being made through GAVI Alliance.
In December 2010, Nicaragua became the first country in the developing world to introduce the newest formulation of PCV(13), less than a year after it was introduced in the USA. Since World Pneumonia Day 2010, 23 more countries introduced it, the report claimed.
Surprisingly, India, China, Indonesia, and Burkina Faso had not yet taken any “action’ for the introduction of the new generation PCV vaccines, while Congo, Ethiopia and Kenya had already introduced them.
So is the status with India, Nigeria, China and Indonesia in non-introduction of HiB Vaccine till 2010.
“By tackling pneumonia in these 15 countries alone, we can help eliminate up to three-quarters of the world’s Pneumonia burden, and take one of the biggest steps yet toward achieving Millennium Development Goal 4, a two-thirds reduction in child mortality,” the report observed.
Source: Pneumonia Progress Report 2011. http://worldpneumoniaday.org/wp-content/uploads/2011/11/IVAC-2011_PNEUMONIA_PROGRESS_REPORT.pdf