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  • richardmitnick 4:13 pm on July 29, 2016 Permalink | Reply
    Tags: , Medicine,   

    From SA: “Zika Goes Local in the United States” 

    Scientific American

    Scientific American

    July 29, 2016
    Dina Fine Maron

    1
    Miami-Dade mosquito control worker Carlos Vargas sprays to eradicate the Aedes aegypti mosquito larvae at a home in Miami, Florida, on June 08, 2016. Of the forty different types of mosquito found in Miami -Dade the Aedes aegypti mosquito or yellow fever mosquito is responsible for transmitting diseases such as the Zika Virus. Credit: RHONA WISE/AFP/Getty Images

    Controlling the Zika virus in the United States just got harder. The mosquito- and sexually-transmitted disease has now likely gone local, according to federal public health officials. In at least four instances patients have apparently contracted the virus via a bite from a mosquito in the continental U.S.

    This first recorded instances of local transmission—reported in Florida—signal a shift in the burden of Zika in the mainland U.S., where more than 1,600 people have been diagnosed with it after traveling elsewhere in the Americas or the Caribbean and returning with the virus in their systems. As of July 27 another 15 had acquired the virus via sexual contact with a person who was infected with the virus outside of the mainland U.S.

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    CDC

    The long-anticipated incidences of local transmission are not a surprise. For months Tom Frieden, the director of the U.S. Centers for Disease Control and Prevention, and other top administration officials have said that they expected the virus to crop up in the mainland U.S. in small outbreaks, particularly along the Gulf Coast where mosquito-borne dengue and chikungunya—carried by the same species of mosquitoes that likely carry Zika—have been documented before. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, has repeatedly said to expect dozens or scores of locally-transmitted cases. Most officials believe a large-scale outbreak remains unlikely. Yet whether outbreaks may include one part of the country, a city or part of a city is difficult to predict.

    Florida Gov. Rick Scott said at a news conference Friday that three men and one woman in Miami-Dade and Broward counties had likely contracted the virus via local mosquito bites, after officials could not explain the infection in any other way. The patients had not recently traveled to a place where Zika is actively spreading, nor had they been in close contact with someone who had been traveling in such areas.

    “All the evidence we have seen indicates that this is mosquito-borne transmission that occurred several weeks ago in several blocks in Miami,” Frieden said in a CDC news release. “We continue to recommend that everyone in areas where Aedes aegypti mosquitoes are present—and especially pregnant women—take steps to avoid mosquito bites. We will continue to support Florida’s efforts to investigate and respond to Zika and will reassess the situation and our recommendations on a daily basis.”

    The two mosquito species typically responsible for spreading the virus are present in more than two-thirds of the U.S. Their range extends from the southern part of the country into parts of the Midwest and the Northeast. But many factors have to align in order for the mosquitoes to pass on the virus. First, a female mosquito (males do not bite) must feed on a human carrying the virus. Next the virus must incubate in the mosquito’s body for about a week, and only then can it be transmitted if the insect bites another human. The adult lifespan of a mosquito is typically only a few weeks, so the virus has a better chance of spreading if its host can feed in a densely packed area—like a city. Conveniently for the virus, these mosquitoes like to live alongside humans and are frequently found in the home or breeding in small pools of standing water in people’s yards.

    Zika symptoms are usually mild and may include rash or fever, although most patients do not even feel sick. The Zika response has instead focused on protecting pregnant women from contracting the virus because it can lead to birth defects including microcephaly, a condition where babies are born with abnormally small heads. (The World Health Organization has also said that there is “scientific consensus” that the virus can cause the sometimes-paralyzing autoimmune disease Guillain-Barre Syndrome in patients of any age.) To help control local Zika spread, public health officials have reiterated calls for people to eliminate standing water from around their homes and to try to avoid mosquito bites by wearing long sleeves, long pants and approved bug sprays.

    “We anticipate that there may be additional cases of ‘homegrown’ Zika in the coming weeks,” Lyle Petersen, incident manager for CDC’s Zika virus response, said in the news release. “Our top priority is to protect pregnant women from the potentially devastating harm caused by Zika.”

    The CDC and health officials have already gained some experience by trying to control the spread of Zika in U.S. territories. To date, Puerto Rico has represented the frontlines of the U.S. battle with more than 4,600 cases of the virus locally transmitted by mosquitoes. Public health officials there have ramped up their mosquito control efforts and their messaging urging people to protect themselves against bites. But they have faced myriad obstacles, including mosquitoes’ resistance to certain common insecticides and the fact that many buildings do not have screens in their windows. The heavy burden of controlling Zika prompted the U.S. territory to begin importing all of the blood it might need for medical procedures from the mainland in March, and to freeze prices for bug spray and condoms to stave off Zika-related price gouging. “Nothing about Zika is going to be easy or quick,” Frieden said in April. “The control of this particular mosquito is hard and although we are learning a lot quickly there is still a lot we don’t know.”

    See the full article here .

    YOU CAN HELP FIND A CURE FOR THE ZIKA VIRUS.

    There is a new project at World Community Grid [WCG] called OpenZika.
    Zika
    Image of the Zika virus, Image copyright John Liebler, http://www.ArtoftheCell.com

    Rutgers Open Zika

    WCG runs on your home computer or tablet on software from Berkeley Open Infrastructure for Network Computing [BOINC]. Many other scientific projects run on BOINC software.Visit WCG or BOINC, download and install the software, then at WCG attach to the OpenZika project. You will be joining tens of thousands of other “crunchers” processing computational data and saving the scientists literally thousands of hours of work at no real cost to you.

    This project is directed by Dr. Alexander Perryman a senior researcher in the Freundlich lab, with extensive training in developing and applying computational methods in drug discovery and in the biochemical mechanisms of multi-drug-resistance in infectious diseases. He is a member of the Center for Emerging & Re-emerging Pathogens, in the Department of Pharmacology, Physiology, and Neuroscience, at the Rutgers University, New Jersey Medical School. Previously, he was a Research Associate in Prof. Arthur J. Olson’s lab at The Scripps Research Institute (TSRI), where he ran the day-to-day operations of the FightAIDS@Home project, the largest computational drug discovery project devoted to HIV/AIDS, which also runs on WCG. While in the Olson lab, he also designed, led, and ran the largest computational drug discovery project ever performed against malaria, the GO Fight Against Malaria project, also on WCG.

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    Scientific American, the oldest continuously published magazine in the U.S., has been bringing its readers unique insights about developments in science and technology for more than 160 years.

     
  • richardmitnick 9:09 am on July 29, 2016 Permalink | Reply
    Tags: , Fungal infection, Medicine,   

    From Stanford: “New study provides deep dive into deadly fungal infections” 

    Stanford University Name
    Stanford University

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    No image caption. No image credit.

    Fungi lack the big name players fielded by the viruses — such as HIV and Zika — or the bacteria — think salmonella, streptococcus. But that doesn’t mean their infections are any less problematic.

    A new study from University of Maryland School of Medicine researchers and colleagues examines a group of fungi from the Mucorales order, which cause infections known as mucormycosis.

    These largely soil-dwelling microbes usually attack people with weakened immune systems, transplant patients, those with uncontrolled diabetes or someone who has suffered a trauma or burn. (For example, there was a fungal outbreak following the 2011 tornado in Joplin, Mo. and the 2004 Indonesian tsunami, and there have been cases from soldiers injured in Iraq and Afghanistan.)

    The researchers examined how the fungi cause infections as well as the genetic relationships between different species. “I think this work is going to provide a significant resource for future fungal research. Now we can dig into the data to find new targets for treatment,” said co-lead author Vincent Bruno, PhD, assistant professor of microbiology and immunology at the University of Maryland School of Medicine, in a press release. The release continues:

    “The researchers say they have identified a pathway that has the potential to be targeted to treat these infections. It appears that these fungi are less able to invade human cells after the inhibition of a protein called platelet-derived growth factor receptor (PGDFR), which plays a key role in cell growth.”

    It’s possible that some drugs already in use may block these infections, according to Bruno, and co-lead author Ashraf Ibrahim, PhD, a professor of medicine at the University of California-Los Angeles Medical Center and a researcher at LA BioMed, a nonprofit biomedical research group.

    That’s good news, as “antifungal therapy alone is rarely curative,” the researchers write: Its mortality rate ranges from about 50 percent, to more than 90 percent.

    The study appeared in Nature Communications.

    See the full article here .

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    Leland and Jane Stanford founded the University to “promote the public welfare by exercising an influence on behalf of humanity and civilization.” Stanford opened its doors in 1891, and more than a century later, it remains dedicated to finding solutions to the great challenges of the day and to preparing our students for leadership in today’s complex world. Stanford, is an American private research university located in Stanford, California on an 8,180-acre (3,310 ha) campus near Palo Alto. Since 1952, more than 54 Stanford faculty, staff, and alumni have won the Nobel Prize, including 19 current faculty members

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  • richardmitnick 6:48 am on July 29, 2016 Permalink | Reply
    Tags: , , Medicine, , Team of Proteins Works Together to Turn on T Cells   

    From Caltech: “Team of Proteins Works Together to Turn on T Cells” 

    Caltech Logo

    Caltech

    07/15/2016
    Whitney Clavin
    (626) 395-1856
    wclavin@caltech.edu

    1
    Researchers imaged cells to identify proteins that affect the expression of a genetic switch for T cells. On the right, T cells where the switch is activated glow in yellow. On the left, the rainbow pattern, a hierarchical cluster analysis, tells researchers which genes are controlled by the switch. The horizontal stripes are the genes. If they stripes turn red going from left to right, it means they are turning on; if they turn blue, the genes are turning off. Credit: Caltech

    The fates of various cells in our bodies—whether they become skin or another type of tissue—are controlled by genetic switches. In a new study, Caltech scientists investigate the switch for T cells, which are immune cells produced in the thymus that destroy virus-infected cells and cancers. The researchers wanted to know how cells make the choice to become T cells.

    “We already know which genetic switch directs cells to commit to becoming T cells, but we wanted to figure out what enables that switch to be turned on,” says Hao Yuan Kueh, a postdoctoral scholar at Caltech and lead author of a Nature Immunology report about the work, published on July 4.

    The study found that a group of four proteins, specifically DNA-binding proteins known as transcription factors, work in a multi-tiered fashion to control the T-cell genetic switch in a series of steps. This was a surprise because transcription factors are widely assumed to work in a simultaneous, all-at-once fashion when collaborating to regulate genes.

    The results may ultimately allow doctors to boost a person’s T-cell population. This has potential applications in fighting various diseases, including AIDS, which infects mature T cells.

    “In the past, combinatorial gene regulation was thought to involve all the transcription factors being required at the same time,” says Kueh, who works in the lab of Ellen Rothenberg, Caltech’s Albert Billings Ruddock Professor of Biology. “This was particularly true in the case of the genetic switch for T-cell commitment, where it was thought that a quorum of the factors working simultaneously was needed to ensure that the gene would only be expressed in the right cell type.”

    The authors report that a key to their finding was the ability to image live cells in real-time. They genetically engineered mouse cells so that a gene called Bcl11b—the key switch for T cells—would express a fluorescent protein in addition to its own Bcl11b protein. This caused the mouse cells to glow when the Bcl11b gene was turn on. By monitoring how different transcription factors, or proteins, affected the activation of this genetic switch in individual cells, the researchers were able to isolate the distinct roles of the proteins.

    The results showed that four proteins work together in three distinct steps to flip the switch for T cells. Kueh says to think of the process as a team of people working together to get a light turned on. He says first two proteins in the chain (TCF1 and GATA3) open a door where the main light switch is housed, while the next protein (Notch) essentially switches the light on. A fourth protein (Runx1) controls the amplitude of the signal, like sliding a light dimmer.

    “We identify the contributions of four regulators of Bcl11b, which are all needed for its activation but carry out surprisingly different functions in enabling the gene to be turned on,” says Rothenberg. “It’s interesting—the gene still needs the full quorum of transcription factors, but we now find that it also needs them to work in the right order. This makes the gene respond not only to the cell’s current state, but also to the cell’s recent developmental history.”

    Team member Kenneth Ng, a visiting student from California Polytechnic State University, says he was surprised by how much detail they could learn about gene regulation using live imaging of cells.

    “I had read about this process in textbooks, but here in this study we could pinpoint what the proteins are really doing,” he says.

    The next step in the research is to get a closer look at precisely how the T cell genetic switch itself works. Kueh says he wants to “unscrew the panels” of the switch and understand what is physically going on in the chromosomal material around the Bcl11b gene.

    The Nature Immunology paper, titled, Asynchronous combinatorial action of four regulatory factors activates Bcl11b for T cell commitment, includes seven additional Caltech coauthors: Mary Yui, Shirley Pease, Jingli Zhang, Sagar Damle, George Freedman, Sharmayne Siu, and Michael Elowitz; as well as a collaborator at the Fred Hutchinson Cancer Research Center, Irwin Bernstein. The work at Caltech was funded by a CRI/Irvington Postdoctoral Fellowship, the National Institutes of Health, the California Institute for Regenerative Medicine, the Al Sherman Foundation, and the Louis A. Garfinkle Memorial Laboratory Fund.

    See the full article here .

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    The California Institute of Technology (commonly referred to as Caltech) is a private research university located in Pasadena, California, United States. Caltech has six academic divisions with strong emphases on science and engineering. Its 124-acre (50 ha) primary campus is located approximately 11 mi (18 km) northeast of downtown Los Angeles. “The mission of the California Institute of Technology is to expand human knowledge and benefit society through research integrated with education. We investigate the most challenging, fundamental problems in science and technology in a singularly collegial, interdisciplinary atmosphere, while educating outstanding students to become creative members of society.”
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  • richardmitnick 10:46 am on July 28, 2016 Permalink | Reply
    Tags: Antibiotic research, , BARDA, , CARB-X, Medicine, Washington Post   

    From Washington Post via Broad Institute: “Major global partnership to speed antibiotic development launched” 

    Broad Institute

    Broad Institute

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    Washington Post

    July 28, 2016
    Lena H. Sun

    2
    Carbapenem-resistant Enterobacteriaceae, or CRE, is considered “nightmare bacteria” because of its resistance to many antibiotics. (Reuters)

    U.S. and British officials announced an ambitious collaboration Thursday designed to accelerate the discovery and development of new antibiotics in the fight against one of the modern era’s greatest health threats: antibiotic resistance.

    CARB-X, for Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator, will create one of the world’s largest public-private partnerships focused on preclinical discovery and development of new antimicrobial products.

    The undertaking includes two agencies within the U.S. Health and Human Services Department that focus on biomedical research and Britain’s Wellcome Trust, a London-based global biomedical research charity. It also includes academic, industry and other nongovernmental organizations.

    [The superbug that doctors have been dreading just reached the U.S.]

    The partnership is committed to providing $44 million in funding in the first year and up to $350 million in new funds over five years to increase the number of antibiotics in the drug-development pipeline. The ultimate goal, officials said, is to move promising antibiotic candidates through the critical early stages so they can attract enough private or public investment for advanced development and win approval by U.S. and British regulatory agencies.

    Biomedical innovations often take place in small companies and academic labs that don’t have the resources and expertise to move products to clinical development. CARB-X aims to provide necessary funding for research and development and technical assistance to move products from proof of concept through preclinical development.

    Only 37 antibiotics are currently in clinical development in the United States, according to The Pew Charitable Trusts. Historically, only about 1 in 5 infectious-disease drugs that enter Phase 1 trials will receive approval from the Food and Drug Administration. There have been no new classes of antibiotics discovered since 1984, according to Pew’s antibiotic resistance project.

    “The establishment of CARB-X is a watershed moment,” Nicole Lurie, a top HHS official in charge of preparedness and response, said during a press briefing Thursday.

    These life-saving drugs are fundamental to modern medicine. They are essential for treating everything from routine skin infections to strep throat and for protecting vulnerable patients receiving chemotherapy or those hospitalized in intensive care units. But the speedy rise of antibiotic-resistant bacteria, which experts say is a result of decades of overuse in animal agriculture and human medicine combined with lagging drug development and innovation, has put people everywhere on the brink of what many public health leaders say is a “post-antibiotic” world. In such a world, even the most simple surgical procedure could have fatal consequences.

    Overseeing the project on the U.S. side is the Biomedical Advanced Research and Development Authority, or BARDA. The HHS agency works on national preparedness for chemical and biological threats. It will be joined by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.

    On the British side, oversight will be led by the Wellcome Trust and the AMR Centre, a public-private initiative formed in February to spur development of new antibiotics and diagnostics.

    “Today the world can be a little more optimistic that we can together tackle this challenge,” said Stephen Caddick, director of innovation for the Wellcome Trust.

    Public health leaders said the project has tremendous potential to jump-start drug development.

    “There are a lot of companies that have potential new antibiotics or other therapies, but it’s a very tough environment to raise funds in,” said Allan Coukell, one of Pew’s top antibiotic experts. “The market for these products are generally small. Creating an economic incentive where they can tap into capital to get these products developed and also access some expertise has the potential to have a real impact.”

    CARB-X will be headquartered at Boston University’s School of Law, where the project’s executive team will be led by Kevin Outterson, a leading health law researcher who will serve as principal investigator on the cooperative agreement.

    Outterson said the initial focus will be on superbugs and other pathogens that the Centers for Disease Control and Prevention has deemed to be serious or urgent threats to public health. They include a particularly dangerous family of bacteria known as CRE, or carbapenem-resistant Enterobacteriaceae, which health officials have dubbed “nightmare bacteria.”

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    Two U.S. nonprofit life-science accelerators will provide support for early-stage antibiotic development projects: Massachusetts Biotechnology Council in Cambridge, Mass., and the California Life Sciences Institute of South San Francisco.

    BARDA is already working directly with drug companies to support nine new antibiotics that could move into the market in the next one to three years, said Joe Larsen, acting deputy director at BARDA. The goal for CARB-X is to work on about 20 different drug candidates at any given time. “Our target is that at a minimum, two products make it to human testing in five years,” he said.

    During the planning process, Larsen said industry and venture capital executives identified preclinical development as the largest need. Securing funding to conduct studies in animals is particularly challenging, and many trials fail in that phase.

    NIAID Director Anthony Fauci said his institute would be able to provide the in-kind research and support services, such as animal models, for that crucial preclinical investigation.

    Here is what each organization is committing:

    •BARDA will provide $30 million during the first year and up to $250 million during the five-year project.

    •The AMR Centre aims to provide $14 million in the first year and up to $100 million over five years.

    •The Wellcome Trust will contribute additional funding from its existing resources and expertise in overseeing projects of this kind.

    •NIAID, which leads the U.S. government in biomedical research on infectious diseases, will provide in-kind research support and technical support related to early-stage antibiotic drug discovery and product development.

    See the full article here .

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    The Eli and Edythe L. Broad Institute of Harvard and MIT is founded on two core beliefs:

    This generation has a historic opportunity and responsibility to transform medicine by using systematic approaches in the biological sciences to dramatically accelerate the understanding and treatment of disease.
    To fulfill this mission, we need new kinds of research institutions, with a deeply collaborative spirit across disciplines and organizations, and having the capacity to tackle ambitious challenges.

    The Broad Institute is essentially an “experiment” in a new way of doing science, empowering this generation of researchers to:

    Act nimbly. Encouraging creativity often means moving quickly, and taking risks on new approaches and structures that often defy conventional wisdom.
    Work boldly. Meeting the biomedical challenges of this generation requires the capacity to mount projects at any scale — from a single individual to teams of hundreds of scientists.
    Share openly. Seizing scientific opportunities requires creating methods, tools and massive data sets — and making them available to the entire scientific community to rapidly accelerate biomedical advancement.
    Reach globally. Biomedicine should address the medical challenges of the entire world, not just advanced economies, and include scientists in developing countries as equal partners whose knowledge and experience are critical to driving progress.

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  • richardmitnick 10:25 am on July 28, 2016 Permalink | Reply
    Tags: , , Indoor tanning, Medicine, Rutgers Cancer Institute of New Jersey   

    From Rutgers: “Indoor Tanning Rates among New Jersey Teens Remain Stable Following State Enactment of Under Age 17 Ban” 

    Rutgers University
    Rutgers University

    1
    Rutgers Cancer Institute of New Jersey

    3

    July 20, 2016

    Michele Fisher
    732-235-9872
    michele.fisher@rutgers.edu

    Research from Rutgers Cancer Institute of New Jersey and Rutgers School of Public Health shows no significant decline in indoor tanning rates among children under age 17 following a ban on such use in New Jersey enacted in 2013. The authors say it’s a finding that underscores a need for continued surveillance of this population and ongoing monitoring of indoor tanning facilities. The work, which appears in the latest edition of the Journal of the American Academy of Dermatology, also found an increase in tanning rates among male high school students in the Garden State from 2012 to 2014.

    Indoor tanning exposes users to damaging ultraviolet rays, which can lead to skin cancer. According to the Centers for Disease Control and Prevention, this practice is particularly dangerous for those who begin indoor tanning in their teens or early adulthood, as it puts them at a higher risk of developing melanoma, the deadliest of all skin cancers. On October 1, 2013, commercial indoor tanning was banned in New Jersey for those under 17 years of age. Investigators sought to examine whether there was a difference in indoor tanning use by New Jersey high school students after the state restriction was enacted.

    Data for the study were drawn from the 2012 and 2014 New Jersey Youth Tobacco Surveys, in which a combined 5,700 public school students in grades nine through 12 in New Jersey participated. While the surveys primarily focused on tobacco-related issues, they also included several questions related to indoor tanning. Along with providing demographic information pertaining to sex, age and race/ethnicity, survey participants reported the number of times they engaged in indoor tanning in the previous year. The 2014 survey captured results during the period when the under-17 ban in New Jersey was in effect.

    In the 2014 survey, 6.9 percent of students under the age of 17 years reported indoor tanning in the past year. This indoor tanning rate was not significantly different than the 6.7 percent rate reported in the 2012 survey. Additionally, the indoor tanning rates in the 2014 survey did not differ significantly from those in the 2012 survey for those aged 17 years and older. Among students of all ages, the past year indoor tanning rate did not differ significantly from 2012 to 2014 for female students, but among male students the rate increased from 5.8 percent to 8.6 percent during that period.

    “The fact that indoor tanning rates among New Jersey high school students under age 17 did not significantly decline after an age restriction was enacted is cause for concern and speaks to the need for ongoing surveillance of indoor tanning rates for this population. These results also highlight a need for continued monitoring of tanning facility operators to ensure they are adhering to the age restrictions put in place,” notes Elliot J. Coups, PhD, behavioral scientist at Rutgers Cancer Institute and associate professor of medicine at Rutgers Robert Wood Johnson Medical School, who is the lead author. “Additionally, the increase in tanning rates among male high school students in New Jersey during the survey period underlines the importance of implementing public health programs targeting varying demographic groups.”

    The authors also note the use of indoor tanning devices in private homes is not subject to age restrictions but should be addressed by future legislation. “Future research is needed to examine youth indoor tanning behaviors, including a focus on the settings in which they tan and the impact of legislative and educational initiatives on such behaviors,” adds Dr. Coups.

    Along with Coups, the authors include Jerod L. Stapleton, PhD, Rutgers Cancer Institute and Rutgers Robert Wood Johnson Medical School; and Cristine D. Delnevo, PhD, MPH, Rutgers Cancer Institute and Rutgers School of Public Health.

    The 2012 and 2014 New Jersey Youth Tobacco Surveys, from which data for this study were drawn, were funded by a contract from the New Jersey Department of Health to the Center for Tobacco Studies at Rutgers School of Public Health.

    About Rutgers Cancer Institute of New Jersey
    Rutgers Cancer Institute of New Jersey (www.cinj.org) is the state’s only National Cancer Institute-designated Comprehensive Cancer Center. As part of Rutgers, The State University of New Jersey, the Cancer Institute of New Jersey is dedicated to improving the detection, treatment and care of patients with cancer, and to serving as an education resource for cancer prevention. Physician-scientists at Rutgers Cancer Institute engage in translational research, transforming their laboratory discoveries into clinical practice. To make a tax-deductible gift to support the Cancer Institute of New Jersey, call 848-932-8013 or visit http://www.cinj.org/giving. Follow us on Facebook at http://www.facebook.com/TheCINJ.

    The Cancer Institute of New Jersey Network is comprised of hospitals throughout the state and provides the highest quality cancer care and rapid dissemination of important discoveries into the community. Flagship Hospital: Robert Wood Johnson University Hospital. System Partner: Meridian Health (Jersey Shore University Medical Center, Ocean Medical Center, Riverview Medical Center, Southern Ocean Medical Center, and Bayshore Community Hospital). Affiliate Hospitals: JFK Medical Center, Robert Wood Johnson University Hospital Hamilton (CINJ Hamilton), and Robert Wood Johnson University Hospital Somerset.

    About Rutgers School of Public Health
    The Rutgers School of Public Health provides an exceptional, high-quality education that is accessible, affordable and designed to accommodate both working professionals and full-time students. The School offers five degrees, including the Master of Public Health (MPH), an MS in Biostatistics, an MS in Health Outcome, Policy, and Economics, a PhD in Public Health and the Doctor of Public Health (DrPH), as well as a number of dual degrees and post-baccalaureate certificates. With educational opportunities offered in New Brunswick and Newark, the School is conveniently accessible across the state. There are eight concentration areas, including Biostatistics, Dental Public Health, Environmental and Occupational Health, Epidemiology, Global Public Health, Health Education and Behavioral Science, Health Systems and Policy, and Urban Health Administration. Students have opportunities to participate in leading public health research and can put their public health education into practice through participation in the School’s international health or community service projects. Numerous continuing education opportunities for public health professionals are also available.

    See the full article here .

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    Rutgers, The State University of New Jersey, is a leading national research university and the state’s preeminent, comprehensive public institution of higher education. Rutgers is dedicated to teaching that meets the highest standards of excellence; to conducting research that breaks new ground; and to providing services, solutions, and clinical care that help individuals and the local, national, and global communities where they live.

    Founded in 1766, Rutgers teaches across the full educational spectrum: preschool to precollege; undergraduate to graduate; postdoctoral fellowships to residencies; and continuing education for professional and personal advancement.
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  • richardmitnick 8:57 am on July 28, 2016 Permalink | Reply
    Tags: Medicine, Nasal Bacteria Pump Out a Potential New Antibiotic That Kills MRSA,   

    From SA: “Nasal Bacteria Pump Out a Potential New Antibiotic That Kills MRSA” 

    Scientific American

    Scientific American

    July 27, 2016
    Anna Vlasits

    1
    Credit: RusN/Getty Images

    Humans, and the microbes that live inside us, could be the source of the next generation of antibiotics.

    German researchers just discovered an antibiotic produced by bacteria that inhabit our noses. This new antibiotic can kill MRSA, the poster child for drug resistance and the culprit behind the most pernicious hospital-acquired staph infections.

    “Our study can help to understand what we can do to eradicate these pathogens from the microbiota of healthy people,” said Andreas Peschel, lead author of the study, published Wednesday in Nature.

    Here’s how it works: Think of our bodies as garden beds, with bacteria as the plants. We used to think that all bacteria were weeds, invading and making us sick. To get rid of bacteria, we just hacked everything down.

    “We’ve taken basically a ‘clear cutting’ approach to treating disease—just whack ‘em all and hope that something good happens,” said Michael Gilmore, a professor of microbiology at Harvard Medical School who reviewed the study and is an expert in antibiotic resistance and drug discovery.

    Instead, something bad happened: overuse and poor compliance led to antibiotic resistance. MRSA infection—caused by staph that don’t respond to methicillin—kills around 20,000 people each year. Around 30 percent of people have the bacteria species that includes MRSA, S. aureus, in their noses right now. The authors point out that the nose is a common entryway for MRSA to get into the human body.

    “Some people are prone to staph infections and other people are relatively resistant,” Gilmore said. “Part of that is our immune system, and part of it is the other microbes that we carry around with us.”

    And it’s those other microbes, the German team found, that strike MRSA dead.

    A native species

    Scientists at the University of Tübingen sucked the bacteria-laden snot from 37 healthy people and cultured the different bacteria species they found in their samples. To figure out if any of the bacteria they’d found would help keep MRSA away, they planted S. aureus alongside the other snot species, and watched them grow.

    The winner, another staph species called S. lugdunensis, was killing S. aureus. Its weapon of choice? A small compound dubbed lugdunin.

    When the researchers tested the new compound in mice, they could treat staph infections. Study author Bernhard Krismer pointed out that “the compound penetrated the tissue and also acted in the deeper layers of the skin,” a useful trick for treating deep-rooted staph infections that are the hallmark of MRSA.

    And when they left S. aureus and lugdunin together for a month, S. aureus still hadn’t developed resistance to it, suggesting that lugdunin is really tough to beat, Krismer said.

    The researchers then checked snot from hospitalized patients. Of 187 samples, all but one were colonized by either S. aureus or S. lugdunensis, but not both. The researchers think where one species grows, the other can’t.

    And it’s all about the lugdunin. When the researchers messed up the lugdunin gene in S. lugdunensis, S. aureus had no trouble growing.

    In other words, human gardens have a native plant that kills a potentially deadly weed.

    The German researchers who performed the study have filed a patent for lugdunin and are hoping to work with pharmaceutical companies to develop it.

    Super bugs and super heroes

    In the clinic right now, “we’re using broad spectrum oral bioavailable drugs that are decimating our own microbiome in order to treat a tooth infection or an ear infection,” Gilmore said.

    Gilmore thinks the time is right to rethink our antimicrobial strategy. This Nature study is a promising direction, he said.

    “What I think the next era is, and I think we’re turning the corner on this, is effectively managing the association between microbes and humans in both health and disease,” he said.

    For instance, doctors could focus more on applying antibiotics locally to just the infected area, especially in the case of infections that are easy to reach, like periodontal disease and ear infections. By selectively treating only serious infections, we might be able to stave off the next round of resistance.

    The German researchers think there are tons of bacteria with secret powers waiting to be discovered —super heroes to fight off super bugs. One comes from bacteria that naturally inhabit vaginal mucus.

    But the newest work takes a step further by showing that S. lugdunensis can block MRSA from taking root in the body at all. “That’s a big deal,” said Michael Fischbach, the UCSF researcher who led the vaginal mucus findings, “since preventing S. aureus from growing in the nostril is an important challenge in preventing staph infections.” (Fischbach works with several biopharma companies and sits on the board of directors of Achaogen, a company that’s developing antibiotics.)

    Probiotic potential

    In addition to trying to develop lugdunin as an antibiotic drug, the new findings suggest that we might be able to seed specific parts of our bodies with commensal bacteria in the form of probiotics.

    Currently, over-the-counter probiotics are made from bacteria that don’t normally inhabit humans, so they get digested. On the other hand, a probiotic made from commensal bacteria could stick around for a long time and alter the flora of whatever part of the body is out of whack. This is the idea behind fecal transplants.

    However, Peschel said, “S. lugdunensis itself is maybe not the perfect probiotic bacteria that you would like to propagate in the nose of an [at]-risk patient who is immune-compromised” because this species occasionally makes people sick.”

    Getting around that will take some tricks. For instance, the German researchers plan to make a GMO combining genes from S. lugdunensis and another, more benign bacterium.

    While we’re still years away from seeing any of these natural killers or probiotics come to fruition in the clinic, the future is much less grim than previously thought.

    On the other hand, it could be another quick respite in the ongoing arms race between bacteria and antibiotics.

    While researchers are excited at the thought of site-specific probiotics, others worry that, once such treatments are used, pathogenic bacteria will figure out how to beat these antibiotics too.

    “I wouldn’t bet against a wily bacterium like S. aureus,” Fischbach, the UCSF researcher, said.

    See the full article here .

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  • richardmitnick 11:54 am on July 27, 2016 Permalink | Reply
    Tags: , For Whom the Births (and Worms) Toll, Medicine,   

    From UCSB: “For Whom the Births (and Worms) Toll” 

    UC Santa Barbara Name bloc

    UC Santa Barbara

    July 21, 2016
    Jim Logan

    1
    Tsimane children. No image credit

    2
    Tsimane women. Photo Credit: Lisa McAllister

    Human childbirth is not only unpleasant, it’s also assumed to take a toll on women’s health, even while women have a greater life expectancy. A new study led by UC Santa Barbara researchers, however, finds that indigenous women in the Bolivian Amazon with some of the highest birth rates in the world today experience negligible health costs from their intense reproductive effort.

    The study tracking 869 Tsimane women over 12 years is the most comprehensive under natural conditions ever conducted, said Michael Gurven, a professor of anthropology at UCSB and the lead author of Health Costs of Reproduction Are Minimal Despite High Fertility, Mortality and Subsistence Lifestyle, published in Nature Scientific Reports. The findings are remarkable because they run counter to expectations, he noted, given that the Tsimane live as horticulturalist-foragers in a harsh environment with limited food and an abundance of pathogens and parasites.

    It is often thought that costly (“cell-mediated”) immune function is suppressed during pregnancy to help tolerate the growing fetus, and so exposure to harmful pathogens should be dangerous. Tsimane growth is also stunted due to limited nutrition and long periods of parasitic exposure. In this environmental context, the average Tsimane woman has nine births in rapid order, and each child is breastfed for nearly two years.

    “One might expect such high, cumulative reproductive costs to take its toll on a woman’s health if her body doesn’t have a chance to recover,” Gurven explained. “Yet we found — using common metrics of maternal health and nutritional status such as weight and body mass index, and some biomarkers assessing anemia and immune activation — that although women with more kids spaced closer together tended to have lower weight and BMI than those with fewer kids spaced further apart — when we looked at changes within women over time, these anthropometric measures increased over successive births.” American women, by contrast, typically gain weight with each successive pregnancy, but they have only a few children and are well nourished, he added.

    Gurven, director of UCSB’s Evolutionary Anthropology and Biodemography Research Group, and co-director of the Tsimane Health and Life History Project, said the findings bring into focus one way that extensive human sociality, or “cooperative breeding,” helps differentiate us from other primates, and has allowed us to swarm the planet. Humans such as the Tsimane who live under natural fertility conditions have a higher birthrate than would be expected of a primate of our size, with infants weaned early and the next child arriving fairly quickly. “Despite rapid reproduction, female hunter-gatherers and horticulturalists typically work less, not more, to meet their greater energetic needs for lactation,” he explained. “This is only possible in a highly social species where others can help out during periods of need.”

    In other species, Gurven said, mothers expend greater energy foraging for food because they’re essentially on their own. Lactating baboons, for example, spend a lot more time looking for something to eat because they don’t have others cooperatively provisioning them. All that extra effort to find more food burns calories, and thereby delays the time at which they start ovulating again.

    “So the Tsimane case is fascinating in this light: Women having nine births spaced close together, yet not experiencing obvious maternal depletion, is a testament to the favorable social structure of humans who actively pool their efforts and resources within and among generations,” Gurven said. “Women not showing evidence of maternal depletion is only possible due to high levels of cooperation from kin and other group members that support women when pregnant and lactating.”

    So are there really no health costs to such high fertility? “Dying in or shortly after childbirth is definitely more common among Tsimane than in high-income countries,” Gurven added, “but here we were more interested in the sustained costs to survivors.” Other health conditions can worsen with successive births among Tsimane. Cystocele — or prolapsed bladder — is one of these, as is lower bone-mineral density and higher risk of osteoporosis, as Gurven, Jonathan Stieglitz (Institute for Advanced Study in Toulouse, France) and his team revealed in a paper by published last year in American Journal of Physical Anthropology.

    The metabolic costs of immune defense against pathogens

    Though living in a pathogenic world typical of the preindustrial past does not appear to make reproduction more costly for women, it does impact the immune system in important ways. A study by Gurven’s group, led by his colleague Aaron Blackwell earlier this year, revealed how the Tsimane’s immune system has risen to the challenge to tolerate or defend against the diverse onslaught of micro-critters.

    Now a new paper by Gurven, Megan Costa, a visiting demographer to UCSB’s Broom Demography Center, Benjamin Trumble, a postdoctoral fellow in UCSB’s Institute for Social, Behavioral and Economic Research, Blackwell and colleagues reports that the Tsimane have a high resting metabolic rate (RMR) and total daily energy expenditure (TDEE) — meaning they burn more calories per pound of body weight per day than sedentary industrialized populations. For Tsimane women, their RMR is 18 to 47 percent higher than expected and for men it’s 22 to 40 percent. The researchers show that higher levels of physical activity and other factors cannot account for the higher energy expenditure. Among Tsimane, those with clinical symptoms of intestinal worms and high white blood cell count indicative of active infection had 10 to 15 percent higher RMR. This amounts to roughly 150 extra calories per day, or the equivalent of a 12-ounce can of Coca-Cola.

    Total daily energy expenditure has its limits, so with extra energy spent on fighting infection, and energy spent producing children and intensive breastfeeding, what areas of health have to take a hit? This is a question Gurven’s team is currently tackling with ongoing biomedical surveillance. Some possibilities include low bone mineral mass, anemia, altered blood lipid profile, lethargy and other sickness behavior. Consistent with these diversions of energy, Tsimane bone mineral status and cholesterol levels are substantially lower than among age-matched U.S. peers, and anemia and depressed affect is prevalent in both sexes (but greater in women).

    Another possibility is that investing less in physical growth will result in smaller body size and weight. Indeed, height is stunted and obesity is rare in Tsimane, who have levels of obesity eight to 10 times lower than that of their American age-matched peers. This doesn’t mean, however, that being loaded with pathogens and parasites is a good diet strategy, said Gurven, who noted some snake-oil diet pills dating back to the 1930s have included roundworm eggs or tapeworm parts.

    “Sometimes they work, often they don’t,” Gurven said. “And the harmful effects of infection — from anemia, worms getting into your lungs, bowel obstruction, to name a few — can be fatal. Giardia and amoebas can also help you lose weight, but too rapidly, and often with dehydration and potentially fatal consequences. These parasites can also deprive the body of vital nutrients. Overall, I wouldn’t recommend people dance barefoot in latrines in the hopes of shedding some pounds.”

    The paper, High Resting Metabolic Rate Among Amazonian Forager-Horticulturalists Experiencing High Pathogen Burden, is published in the American Journal of Physical Anthropology.

    See the full article here .

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    UC Santa Barbara Seal
    The University of California, Santa Barbara (commonly referred to as UC Santa Barbara or UCSB) is a public research university and one of the 10 general campuses of the University of California system. Founded in 1891 as an independent teachers’ college, UCSB joined the University of California system in 1944 and is the third-oldest general-education campus in the system. The university is a comprehensive doctoral university and is organized into five colleges offering 87 undergraduate degrees and 55 graduate degrees. In 2012, UCSB was ranked 41st among “National Universities” and 10th among public universities by U.S. News & World Report. UCSB houses twelve national research centers, including the renowned Kavli Institute for Theoretical Physics.

     
  • richardmitnick 11:34 am on July 27, 2016 Permalink | Reply
    Tags: , Can cutting calories help curb memory loss?, , Medicine   

    From Hopkins: “Can cutting calories help curb memory loss?” 

    Johns Hopkins
    Johns Hopkins University

    Jul 22, 2016
    No writer credit found

    1
    Image credit: Alex Robbins

    Eliminating calories might be good for your waistline, but as it turns out, it might be even better for your brain.

    Mark Mattson, a professor of neuroscience in the Johns Hopkins School of Medicine and chief of the Laboratory of Neurosciences at the National Institute on Aging, explains in a recent article in the Johns Hopkins Health Review that cutting energy intake by fasting at least two days a week might help the brain ward off neurodegenerative diseases like Alzheimer’s and Parkinson’s, and even improve memory and mood.

    “Fasting is a challenge to your brain, and we think that your brain reacts by activating adaptive stress responses that help it cope with disease,” Mattson tells the Health Review. “From an evolutionary perspective, it makes sense your brain should be functioning well when you haven’t been able to obtain food for a while.”

    Intermittent fasting, Mattson says, may improve neural connections in the hippocampus and protect neurons against amyloid plaques, which are associated with Alzheimer’s disease. He explains that after eating, glucose is stored in the liver as glycogen. After about 10 to 12 hours, the glycogen is depleted and the body begins to burn fats, which are converted to acidic chemicals called ketone bodies. These ketones promote changes in the structure of the neural synapses that are important for the health of the brain. But eating full meals doesn’t give the body the chance to deplete the glycogen stores in the liver, so ketones aren’t produced.

    Exercise has similar positive effects on the brain. When the brain is challenged by either physical exertion, cognitive tasks, or caloric restriction, the body produces a protein called BDNF (brain-derived neurotrophic factor), which not only strengthens neural connections and increases the production of new neurons but can also have an anti-depressive effect. “Probably during evolution, BDNF evolved to play an important role in increasing neuroplasticity in the brain and forming new synapses crucial to learning and memory as well as mood and motivation,” he tells the Health Review.

    To incorporate fasting into your diet, take a cue from Mattson:

    Mattson recommends people try one of two strategies for incorporating calorie restriction. The first is called the 5:2 diet, which has gained popularity in recent years, particularly in England after the BBC aired a 2012 documentary called Eat Fast and Live Longer in which Mattson was featured. That diet calls for limiting your caloric intake to 500 calories two nonconsecutive days per week while eating a healthy diet in the normal caloric range (2,000 for women; 2,500 for men) the rest of the week. Five hundred calories means maybe a fried egg for breakfast and a small serving of lean protein with vegetables for lunch or dinner.

    Another strategy is a time-restricted diet in which you pack all your meals into one eight-hour period a day so your body has time to exhaust its supply of glycogen, start burning fat, and produce ketones. Mattson says animal studies have shown that the time-restricted diet has effects similar to those of intermittent fasting.

    See the full article here .

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    Johns Hopkins Campus

    The Johns Hopkins University opened in 1876, with the inauguration of its first president, Daniel Coit Gilman. “What are we aiming at?” Gilman asked in his installation address. “The encouragement of research … and the advancement of individual scholars, who by their excellence will advance the sciences they pursue, and the society where they dwell.”

    The mission laid out by Gilman remains the university’s mission today, summed up in a simple but powerful restatement of Gilman’s own words: “Knowledge for the world.”

    What Gilman created was a research university, dedicated to advancing both students’ knowledge and the state of human knowledge through research and scholarship. Gilman believed that teaching and research are interdependent, that success in one depends on success in the other. A modern university, he believed, must do both well. The realization of Gilman’s philosophy at Johns Hopkins, and at other institutions that later attracted Johns Hopkins-trained scholars, revolutionized higher education in America, leading to the research university system as it exists today.

     
  • richardmitnick 11:24 am on July 27, 2016 Permalink | Reply
    Tags: , , , Medicine, T.H. Chan School of Public Health   

    From Harvard: “Study finds induced labor not associated with risk for autism spectrum disorders” 

    Harvard University

    Harvard University

    1
    T.H. Chan School of Public Health

    July 25, 2016
    Marge Dwyer
    617.432.8416
    mhdwyer@hsph.harvard.edu

    2
    No image caption. No image credit.

    Induction of labor appears not to be associated with increased risk of autism spectrum disorders in children in a large new study led by Harvard T.H. Chan School of Public Health. The new finding suggests that concern about autism risk should not factor into clinical decisions about whether or not to induce labor.

    The study will be published online July 25, 2016 in JAMA Pediatrics.

    Autism spectrum disorders (ASD) —a group of permanent developmental disabilities characterized by impairments in social interaction, language development, and repetitive behaviors—are estimated to affect roughly 1 in 90 children in the U.S.

    Labor induction is recommended when labor doesn’t progress on its own and there’s concern that waiting for it to start could endanger the health of the baby or mother. Methods to induce labor include rupturing of membranes, mechanical or pharmacological ripening of the cervix, and administration of oxytocin, either used alone or in combination.

    In 2013, a large study in North Carolina found an association between induction of labor and risk of autism in offspring. The report gained widespread media attention, and although both the paper’s authors and other experts cautioned that the association may not be causal, obstetricians began reporting that some of their patients were expressing concern about or opposition to being induced. The Harvard Chan School researchers decided to further explore whether induction of labor truly causes increased risk of neuropsychiatric disorders, in order to help in weighing the risks and benefits of this common therapeutic intervention.

    “When we used close relatives, such as siblings or cousins, as the comparison group, we found no association between labor induction and autism risk,” said Anna Sara Oberg, research fellow in the Department of Epidemiology at Harvard Chan School and lead author of the study. “Many of the factors that could lead to both induction of labor and autism are completely or partially shared by siblings—such as maternal characteristics or socioeconomic or genetic factors. Finding no association when comparing siblings suggests that previously observed associations could have been due to some of these familial factors—not the result of induction.”

    Working with colleagues from Sweden’s Karolinska Institutet and Karolinska University Hospital, Harvard Medical School, and Indiana University, the Harvard Chan School researchers studied all live births in Sweden from 1992–2005. They followed over 1 million births through 2013, looking for any neuropsychiatric diagnoses and identifying all siblings and maternal first cousins. They also incorporated several measures of the mothers’ health in their analysis.

    Nearly 2% of babies in the study population were diagnosed with autism during the follow-up period, the researchers found. Overall, 11% of the deliveries had involved induction of labor, often occurring in conjunction with pregnancy complications such as gestational diabetes, gestational hypertension, and preeclampsia; 23% of the induced pregnancies were post-term.

    In their initial comparison of individuals who weren’t related to each other, the researchers found an association between labor induction and ASD risk, similar to that previously reported. But when they compared “induction-discordant” siblings (children born to the same mother—in one, labor was induced, in the other, it wasn’t), they no longer saw an association.

    “Overall, these findings should provide reassurance to women who are about to give birth, that having their labor induced will not increase their child’s risk of developing autism spectrum disorders,” said Brian Bateman, anesthesiologist and associate professor of anesthesia at Massachusetts General Hospital and Brigham and Women’s Hospital, Harvard Medical School, and senior author of the study.

    “It is important to note that the findings pertain to the risks associated with labor induction per se, and not the specific method or medication used in the process, including oxytocin,” said Oberg.

    Sonia Hernández-Díaz, professor of epidemiology at Harvard Chan School, was a co-author of the study. Funding for the study came from grants 2012-34 (International Postdoctoral grant) and 340-2013-5867 (Swedish Initiative for Research on Microdata in the Social and Medical Sciences [SIMSAM]) from the Swedish Research Council and grants K08HD075831 and R01HD061817 from the National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health & Human Development.

    “Association of Labor Induction With Offspring Risk of Autism Spectrum Disorders,” Anna Sara Oberg, Brian M. D’Onofrio, Martin E. Rickert, Sonia Hernandez-Diaz, Jeffrey L. Ecker, Catarina Almqvist, Henrik Larsson, Paul Lichtenstein, and Brian T. Bateman, JAMA Pediatrics, online July 25, 2016, doi: 10.1001/jamapediatrics.2016.0965

    See the full article here .

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    Harvard University campus

    Harvard is the oldest institution of higher education in the United States, established in 1636 by vote of the Great and General Court of the Massachusetts Bay Colony. It was named after the College’s first benefactor, the young minister John Harvard of Charlestown, who upon his death in 1638 left his library and half his estate to the institution. A statue of John Harvard stands today in front of University Hall in Harvard Yard, and is perhaps the University’s best known landmark.

    Harvard University has 12 degree-granting Schools in addition to the Radcliffe Institute for Advanced Study. The University has grown from nine students with a single master to an enrollment of more than 20,000 degree candidates including undergraduate, graduate, and professional students. There are more than 360,000 living alumni in the U.S. and over 190 other countries.

     
  • richardmitnick 11:09 am on July 27, 2016 Permalink | Reply
    Tags: , Lucile Packard Children’s Hospital Stanford, Medicine, , Ventricular assist device   

    From Stanford: “22-year-old marks five years of life with mechanical heart pump” A Great Story 

    Stanford University Name
    Stanford University

    7.8.16 [This just appeared in social media.]
    Melissa Schenkman

    Edgar Arredondo has lived with a ventricular assist device for longer than any other patient being treated at Lucile Packard Children’s Hospital Stanford.

    1
    Edgar Arredondo, front, with his sisters, father and mother. Arredondo had a ventricular assist device implanted in his chest at Lucile Packard Children’s Hospital Stanford in 2011.
    Norbert von der Groeben

    When people meet Edgar Arredondo, 22, of Newark, California, they are immediately drawn to his easygoing nature, his positive outlook on life and his unfailing smile. An aspiring graphic designer who has battled Becker muscular dystrophy since elementary school, Arredondo prefers pursuits that allow him to take things at his own pace, tackling them the same way he has taken on the rest of life’s challenges — all in stride.

    It’s an approach that continues to captivate his family, friends and the care team at Lucile Packard Children’s Hospital Stanford Heart Center as he marks an extraordinary five years of living with a ventricular assist device attached to his heart. The device was implanted at Packard Children’s in 2011. “What jumps out at me about Edgar is that he is able to maintain enthusiasm, positivity and grace, all at once, in the face of a series of medical challenges,” said David Rosenthal, MD, director of the hospital’s VAD program and professor of pediatrics at the School of Medicine.

    Arredondo’s personal milestone is also a record for the VAD program: He has been living on a VAD longer than any other pediatric recipient in the hospital’s history, and possibly in the country. To mark this milestone, Arredondo and his family gathered recently in the hospital’s courtyard along with dozens of people from his care team, past and present, including members who were on their day off and those who have retired but who wanted to return for the momentous occasion.

    “Edgar, you have been an inspiration to all who have cared for you,” said Daniel Bernstein, MD, the Alfred Woodley and Mabel Salter Endowed Professor in Pediatrics, who has been closely involved in Arredondo’s care over the years.

    Arredondo wore an ear-to-ear grin as he read aloud from a letter to his supporters, expressing his heartfelt gratitude to all who have helped him along his journey.
    How it all began

    Around age 6, a completely mobile Arredondo noticed that he felt tired when walking long distances and fell more often than his classmates.

    “It was hard to keep up with the other kids,” he said. “When I used to go up the stairs or curbs, it was really hard. Those muscles weren’t as strong, I guess, so I couldn’t do those things.”

    Arredondo’s difficulty with movement was not just on his own radar. His mom and his teachers noticed, too.

    At 9 years old, he had a muscle biopsy. He was diagnosed with Becker muscular dystrophy, a genetic disease that causes muscle breakdown and weakness. It typically affects muscles in the thighs, hips, shoulders and pelvic area.

    Arredondo got around mostly by walking until he entered junior high, when he opted to use a wheelchair to navigate the campus. Other than that, the condition did not faze him. School was going well and he had a loyal group of friends. “They would include me in everything, even if I couldn’t do anything,” he said.

    When he was a high school freshman, Arredondo’s dystrophy began to show its unpredictable side. He felt very weak, had little appetite and often couldn’t keep his food down.

    After a series of tests, it was determined that the disease was affecting a very important muscle: his heart.

    “With muscular dystrophy, you get a dilated cardiomyopathy, a weakness of the heart muscle that is in direct parallel to the skeletal muscle,” Rosenthal said.

    Arredondo was referred by Children’s Hospital Oakland to Lucile Packard Children’s Hospital Stanford, the only pediatric heart transplant center in Northern California.

    It’s a referral his family is very grateful for.

    “Becoming a patient at Stanford was a new opportunity for Edgar to have life,” said Imelda Arredondo, Edgar’s mother. “The doctors and nurses love their work. They worry not just about the patient, but the family, too. No matter your background they treat you good.”

    Ventricular assist device program

    Mending poorly working hearts is nothing new for Packard Children’s. For years, the program has been using medications and VADs to keep children’s hearts functioning while they await a transplant.

    Historically, life with a VAD has meant staying inside the hospital. Rosenthal and his team pioneered the use of durable VADs in kids, building the foundation for a treatment program that includes living at home and going to a mainstream school. The result for many patients is a higher quality of life.

    “In 2010, we started using a VAD called the HeartMate 2, which is totally implanted in the body and has wires on the outside that are easier to care for,” nurse practitioner Aileen Lin, RN, said. “Most places weren’t trying this in kids yet. At the time, it was a huge push in the field.”

    In Arredondo’s case, the pressure in his lungs was too high to allow for an immediate heart transplant, so the care team decided that a VAD would allow the lungs to recover and the pressure to fall so that he could undergo a heart transplant in the future.

    In addition to providing medical care, a significant part of the VAD program is dedicated to educating patients and their families about the device, setting patients on a path to outpatient life.

    “We train parents and siblings how to be ‘VAD active’,” Lin said. “We teach them how to change the batteries and when to call the hospital. We also inform the emergency medical service providers in the community where the patient lives to make them aware.”

    When they were in high school together, Arredondo’s sister Viviana would help him change his batteries every day at lunchtime.

    “We learned to make the VAD a part of our lives. Sometimes when our mom is not home at night, I help Edgar get in bed and connect him to his home monitoring system,” Viviana said.

    The program also addresses patients’ concerns about issues such as body image, being reliant on a machine and getting treated differently. This support makes patients and their families feel confident about living life outside the hospital.

    “Our hospital community is very motivated to be involved in the care of these patients. It takes a lot of manpower to get these kids back to being kids, which is one of the main goals of pediatric VAD support,” said nurse practitioner Jenna Murray, RN, a ventricular assist device coordinator.

    On the horizon

    In Rosenthal’s view, the VAD program is just one example of Packard Children’s commitment to the field of transplantation — and to pushing the envelope in pediatric VAD research.

    Some exciting developments are on the horizon. First is a national trial for a new kind of pediatric VAD, spearheaded by Christopher Almond, MD, assistant professor of pediatric cardiology. There are also plans to organize a national trial of the Berlin Heart, one of the first VADs, to look at alternative ways to provide care that will reduce the risk of stroke for patients.

    “We have had a longstanding interest in how to use VADs in children, and we want to carry that into the future, as well,” said Rosenthal.

    As for Arredondo, he has made a lasting impression on the hearts of his health-care team.

    This is especially true for Lin, who has taken care of him from the beginning and even attended his high school graduation.

    “I feel incredibly lucky to know someone like Edgar and to be a part of his care,” Lin said. “It’s amazing to see him endure all of these things and take it all in stride. He hasn’t missed a step.”

    See the full article here .

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    Leland and Jane Stanford founded the University to “promote the public welfare by exercising an influence on behalf of humanity and civilization.” Stanford opened its doors in 1891, and more than a century later, it remains dedicated to finding solutions to the great challenges of the day and to preparing our students for leadership in today’s complex world. Stanford, is an American private research university located in Stanford, California on an 8,180-acre (3,310 ha) campus near Palo Alto. Since 1952, more than 54 Stanford faculty, staff, and alumni have won the Nobel Prize, including 19 current faculty members

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