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Cholera in Haiti

26 October 2010 – As of the evening of 25 October, the Ministry of Health of the Government of Haiti has reported 3 342 confirmed cases including 259 fatalities. Suspected cases are being investigated in the North and South departments, and five cases have been confirmed in the West Department, where the capital, Port-au-Prince is located.

Currently there are 12 cholera treatment centers being built to support isolation and treatment of cases: six in Artibonite, one in Central, and five in Port-au-Prince.

The emphasis is on prevention by ensuring clean water, promoting good personal hygiene, and food handling practices, including hand washing and trying to prevent defecation in open areas.

As just under half of reported deaths so far are taking place in hospitals, but more than half are in the community, PAHO is in the process of mobilizing experts in the area of proper body disposal to travel to Haiti.

WHO’s Region for the Americas (PAHO) continues to mobilize international experts including epidemiologists, risk communication, case management, laboratory, water and sanitation, logistics, and LSS/SUMA (humanitarian supply management system) to Haiti and also to the Dominican Republic.

PAHO’s PROMESS (Program on Essential Medicine and Supplies) warehouse currently has stocks of medicines and antibiotics, and PAHO is procuring additional stocks of intravenous fluids and medical supplies.

PAHO is also supporting the Water & Sanitation Cluster in Haiti providing powdered chlorine (including supplies from Brazil) for water purification and testing water that is being distributed to settlement camps. PAHO is also making special efforts to ensure clean water in hospitals.

While no cases of cholera have been reported in Dominican Republican, the outbreak has prompted the Government to mobilize a contingency plan in the border area.

PAHO’s Caribbean Epidemiology Center (CAREC) located in Trinidad is helping Caribbean ministries of health to mobilize and be prepared for any potential cases in the other islands.

PAHO continues to coordinate these efforts with other UN agencies, and with health officials in the USA and Canada. Relief efforts continue as the government, MINUSTAH (the United Nations Stabilization Force in Haiti), UN agencies and NGOs are continuing to provide assistance in a growing number of locations.

Source <World Health Organization>

Oh, Perfection

Qui que tu sois, j’écoute. Quoi que tu fasses, tu feras bien.

London, United Kingdom

When a man is tired of London, he is tired of life. – Samuel Johnson

 

Stem Cells

Stem cell treatment goes from lab to operating room

By Miriam Falco, CNN Medical News Managing Editor

May 4, 2010 8:10 a.m. EDT

video

Atlanta, Georgia — Imagine having your back cut open, part of your spine removed, a stabilizing device that resembles a mini oil rig mounted on your back, the outer membrane of your spinal cord sliced open and experimental stem cells injected into it — all for the advancement of science because it’s not expected to benefit you.

John Cornick, 51, did just that earlier this month as part of a groundbreaking clinical trial.

Almost a year ago, Cornick was told he had ALS — better known as Lou Gehrig’s disease. The diagnosis left him “fairly devastated,” he says.

He knew the prospects were grim because there is no cure.

But John wasn’t giving up so quickly, nor was his wife, Gina.

“I knew he was a fighter from the beginning and he really wanted to do something,” Gina Cornick says. She found information about a clinical trial on online and immediately signed him up, even though she had no idea where it was being held.

ALS destroys the nerve cells in the brain and spine which control muscle movement. When the brain can no longer tell muscles to move, they eventually die, depriving the patient of the ability to move arms and legs and eventually breathe.

The goal of this phase 1 trial is to determine whether fetal stem cells can safely be injected into the spinal cord. Ultimately, researchers hope to show that these cells may slow or halt the progression of the fatal disease.

But for now, the only goal is establishing safety.

Clinical trial

The Cornicks live in North Carolina, just a few hours from Atlanta, Georgia’s Emory University, the site of the trial. It is the first FDA-approved clinical trial to inject fetal stem cells directly into the spinal cord of an adult.

Dr. Jonathan Glass, director of Emory’s ALS center, is overseeing the trial. Cornick and two previous patients in the trial are heroes, says Glass, because at this point, the trial will likely produce only information, not results.

“In reality what do these patients have? Time, families and their life and we’re putting all of these at risk,” says Glass.

Dr. Lucie Bruijn, science director of the ALS Association, says the progress being made in this clinical trial is exciting. “We’ve been able to move it forward … from animal testing now into actual patients.” The treatment had not been tried in humans before.

Glass hopes this trial will lead to a new form of treatment for people with ALS. “We’re testing multiple things: We’re testing the safety of the surgery; we’re testing the cells; we’re testing immunosuppressants[because scientists do not know whether the body will reject the cells].” They are also testing how well Cornick handles this major surgical procedure, says Glass.

“After we’re finished with the first 12 or 18 patients we will know whether this is surgery that patients can tolerate.”

As he was prepped for surgery, Cornick was hopeful but realistic. “Well, of course you’d like to get up and walk … but I know that’s not going to happen.”

Stem cells

The stem cells used in the surgery are shipped overnight from Maryland, where Neuralstem, the company funding the trial, is based. The stem cells’ source is donated tissue from the spinal cord of an 8-week old aborted fetus, which was donated to the company. The company has developed a method that enables growth of millions of stem cells from this single source of human nerve stem cells.

Before the surgery can begin, a technician at Emory has to verify that a majority of stem cells made it to Atlanta alive. At least 70 percent have to be viable. In this case three samples under the microscope showed 85 percent of the cells arrived alive.

Lead researcher Dr. Eva Feldman, a neurologist at the University of Michigan, designed the trial just four years ago. After a lot of animal testing, her team determined that using fetal nerve stems rather than human embryonic or adult stem cells (such as bone marrow stem cells) was most effective, she says.

Stem cells have the ability to turn into different cells in the body. However, human embryonic stem cells, which come from 4- or 5-day-old embryos, also been found to sometimes turn into cancer cells. Fetal stem cells, such as those used in this trial, are a few weeks older and have already taken on a specific identity — in this case nerve cells.

Feldman says the fetal stem cells used in this trial did not become any of the unwanted cell types. “That’s very, very important,” she says.

Surgery

Animal testing also proved very useful when it came to figuring out how to actually inject the stem cells. Emory University’s neurosurgeon Dr. Nicholas Boulis invented the device that holds the needle that injects the stem cells. The goal is to inject the cells without injuring the spine and causing even more paralysis. He practiced on 100 pigs before attempting the procedure on a human.

Boulis says it’s critical that the injection be done in a very slow and controlled way.

“If you inject quickly, you’re going to create pressure at the head of the needle and that can cause damage,” Boulis says. That pressure can also inflate an area in the spinal cord which could cause the stem cells to seep back out of the cord when the needle is pulled out, he says. “So by pumping [cells] in slowly you have more security that you are not going to have reflux and you’re not going to have damage.”

Dr. Jeffrey Rothstein, who heads the ALS research center at Johns Hopkins University and is not connected to this trial, said work on this method is a big achievement. “This is purely about how to surgically deliver cellular therapy to spinal cord,” he says. “It’s never been done before.”

After the spinal cord was exposed, the injections began. Cornick got five — each one contains about 100,000 stem cells.

The four-and-a-half hour surgery went smoothly, Boulis, says. “There were no surprises.”

Post-surgery

A day after surgery, Cornick was lying flat in a hospital bed, chatting and laughing with some friends from North Carolina.

One week after surgery, he says he felt amazingly well and was still hopeful the cells would do some good for him.

Two weeks later Cornick’s stitches were removed and he was able to drive home. But he will be making frequent visits back to Atlanta as Glass and his team continue to monitor him.

Neuralstem’s Chief Scientific Officer Karl Johe says after the trial’s safety board reviews all existing data, including Cornick’s results, a fourth patient can be treated with the stem cells.

“Patients Four, Five and Six will receive twice as many [stem cell] injections,” Johe says. They will get five more injections on the other side of the spinal cord compared with Cornicks’s surgery.

Cornick expects the researchers will follow his progress for a long time. He says he understands the need for people to be willing to participate in experimental research like this.

“For me it just seemed like the right thing to do. I almost felt I had an obligation to do this,” he says. “To help other people and myself.”

Genetic Screenings in order to Discriminate?

NCAA genetic screening rule sparks discrimination concerns

By Madison Park, CNN

August 4, 2010 8:13 a.m. EDT

(CNN) — A controversial new rule by the National Collegiate Athletic Association went into effect this month, requiring all Division I athletes to be screened for a genetic sickle cell trait.

While some applauded the new requirement, critics say it could expose players, mainly African-Americans, to genetic discrimination.

he rule requires all incoming student-athletes to get tested for sickle cell trait, show proof of a prior test or sign a waiver if they decline testing.

The mandate was part of a settlement between Rice University and the parents of college football player Dale Lloyd, who carried the sickle cell trait and died during a 2006 workout.

Unlike sickle cell disease, the trait is usually harmless and is inherited through a defective gene passed on by one of the parents.

People who inherit copies of the defective gene from both parents have sickle cell disease. Instead of round, flexible, doughnut shapes, the red blood cells look like rigid rods or sickles. This abnormal shape can clog blood vessels and deprive the body of oxygen.

But people with just sickle cell trait “have normal life spans and can perform just as well as other people in athletics,” said Dr. Martin Steinberg, director of Boston University’s Center of Excellence in Sickle Cell Disease.

While they rarely see complications, their bodies can breakdown during intense exercises or heat-related exertion, doctors said.

Sickle cell trait is found in about 8 percent of African-Americans. It appears in less than 1 percent of whites, although one example is Mark Richt, head coach of the University of Georgia football team, who has a son who tested positive for the trait.

Nine collegiate football players’ deaths have been related to sickle cell trait since 2000, making exertional sickling the leading cause of death in NCAA football players this decade.

While the Sickle Cell Disease Association of America supports athletes knowing their genetic status, the chief medical officer, Dr. Lanetta Jordan, called the latest screening mandate troublesome.

“What we don’t support with the NCAA ruling is that this ruling primarily is based on someone getting sued,” she said. “So it’s not linked to screening for the purpose of genetic counseling or parenting. It’s screening for protection of the universities, not protection of the athlete.”

Schools and coaches might treat athletes with sickle cell trait differently, she said.

“Will recruiters be as quick to recruit someone with sickle cell trait?” Jordan asked. “It’s too early to tell, but will these students have the same opportunities as some without sickle cell trait? We don’t know that.”

The NCAA should follow the military’s lead, Jordan said. Back in the 1970s, the U.S. military screened for sickle cell, but decided to abandon testing in favor of revamping the training protocol to eliminate the risk of heat-related illnesses and exhaustion for everyone.

“The NCAA has not chosen that route,” Jordan said. “The route they chose is to identify everyone. If they are positive, those students will have an alternative practice protocol, which identifies them once again as being different.”

Student athletes have been screened for sickle cell trait for more than a decade at the University of Oklahoma. Scott Anderson, the school’s head athletic trainer, said modifications tailored to an individual’s health needs do not create divisions or fuel discrimination.

“Modifications within sports are not unique to sickle cell trait,” Anderson said. “We know and understand there are settings and circumstances that create risk for them.”

For example, some players do not participate in certain conditioning or use heavy weight loads because of their health needs such as sickle cell trait, diabetes, asthma or muscular-skeletal syndromes.

The NCAA guidelines “emphasize that student-athletes with sickle cell trait should not be excluded from athletics participation,” an association spokeswoman wrote to CNN.com.

The medical field is divided over whether there is enough evidence to warrant the mass screenings (outside from newborns), said Dr. Jeffrey Hord, medical director of the Showers Family Center for Childhood Cancer and Blood Disorders at Akron Children’s Hospital in Ohio.

The exact mechanics of how sickle cell trait is related to the deaths during intense exertion are unclear, he said.

“Were there other conditions that contributed to this? Maybe it’s sickle cell trait with asthma? Are there factors there we don’t recognize at this point?”

Players with the trait should hydrate, pay attention to their bodies and communicate with trainers and coaches, Hord said.

Devard Darling and his twin brother learned they carried the trait when they were screened before joining Florida State University’s football team but were given no further information.

During a February 2001 football practice, Devard saw his twin, Devaughn, with his head slumped slightly with an ice pack on his neck. They exchanged a glance, acknowledging how grueling football practice had been, and parted ways since Devard played offense and Devaughn was on defense.

Devaughn went to mat practice, a series of drills that include dropping to the floor, rolling and sprinting repeatedly.

“It was not really air-conditioned,” Darling recalled. “It’s so hot and muggy in there. You have trash cans for people to throw up in. People are throwing up, passing out or fainting.”

The next time Darling saw Devaughn, the linebacker was on his back, with trainers pumping his chest, trying to resuscitate him. A few hours later, Devaughn, 18, died.

“I have no idea why it happened to Devaughn,” Darling said. “It was in the Lord’s plan.”

Nine years after his brother’s death, Darling supports the NCAA screening.

“I think it’s about time,” he said. “Over the past years, there’s been too many deaths related to it. Kids need to know they have the trait.”

After his brother’s death, Darling played at Washington State University and has played for the National Football League for four seasons without any sickle cell-related incidents. He’s currently a free agent.

The complications are “easily preventable for people who have sickle cell trait,” Darling said. “Number one is to stay hydrated and know when to take breaks. It’s about knowing your body.”

Brain-Powered Prosthetic Limbs

The Future Is Now: Brain-Powered Prosthetic Limbs

By: RACHEL GOLDSTEIN (1 day ago)

With all of the adverse effects technology has yielded, it’s easy to sometimes overlook the exceptional.  In today’s case, that exceptional advancement comes in the form of prosthetic limbs, wait for it, controlled by its user’s mind.

The Johns Hopkins Applied Physics Laboratory (APL), with an awarded $34.5 million contract, is at present testing (on human subjects), the product of its four year program.  Their hope was to develop a model of prosthetics that would use a “brain controlled interface.”

But Johns Hopkins is not alone in its efforts.  Their team is in collaboration with teams from the University of Pittsburgh, the University of Chicago, the California Institute of Technology, the University of Chicago, and others to optimize chances of this project’s success, as each institute possesses different specialties.
(Read about fighting crimes by reading minds.)

Michael McLoughlin, APL’s program manager explains, “The results of this program will help upper-limb amputees and spinal cord injury patients, as well as others who have lost the ability to use their natural limbs, to have as normal a life as possible.”

The developments made my McLoughlin and his team are remarkable.  It’s developments include implantable micro-arrays capable of recording brain signals, in addition to clinical trials demonstrating safely implantable neural interfaces that control the limbs.

“Now, in phase three,” says McLoughlin, “we are ready to test it with humans to demonstrate that the system can be operated with a patient’s thoughts and that it can provide that patient with sensory feedback, restoring the sensation of touch.”
Read more: http://newsfeed.time.com/2010/08/08/the-future-is-now-brain-powered-prosthetic-limbs/?hpt=T2#ixzz0w8yndOsS

Words to Live by…

The life of Man is a long march through the night, surrounded by invisible foes, tortured by weariness and pain, towards a goal that few can hope to reach, and where none may tarry long. One by one, as they march, our comrades vanish from our sight, seized by the silent orders of omnipotent Death. Very brief is the time in which we can help them, in which their happiness or misery is decided. Be it ours to shed sunshine on their path, to lighten their sorrows by the balm of sympathy, to give them the pure joy of a never-tiring affection, to strengthen failing courage, to instil faith in hours of despair. Let us not weigh in grudging scales their merits and demerits, but let us think only of their need — of the sorrows, the difficulties, perhaps the blindnesses, that make the misery of their lives; let us remember that they are fellow-sufferers in the same darkness, actors in the same tragedy as ourselves. And so, when their day is over, when their good and their evil have become eternal by the immortality of the past, be it ours to feel that, where they suffered, where they failed, no deed of ours was the cause; but wherever a spark of the divine fire kindled in their hearts, we were ready with encouragement, with sympathy, with brave words in which high courage glowed.We ought to stand up and look the world frankly in the face. We ought to make the best we can of the world, and if it is not so good as we wish, after all it will still be better than what these others have made of it in all these ages. For my part, I should wish to preach “the will to doubt”. What is wanted is not the will to believe, but the wish to find out, which is the exact opposite.

Cape Cod MA, USA

Life, the ultimate vending machine.  Put money in and get what you want. But aren’t the best things in life supposed to be free? Well I like Reese’s, so I guess I have to work hard.

B4 Please

There are three types of people in this world. People who don’t got dreams. People who got dreams but don’t do nothing about it, and those who go out and fulfill those dreams. I don’t know about you but I’m the third kind.

New York, New York

The Neuromuscular Junction.

Never knowing what people are actually thinking. The Biggest blessing is a head, one with a shield so protective that the only weaknesses are the portals of the eyes; the keyholes of thought and emotion weakly clogged and unfortified. The rods and cones transform to rockets and chests, locked away so tightly yet exploding into the atmosphere at the speed of sound lightyears away to be displayed on the surface of my epidermis. The muscles of the face contract, revealing the slightest bit of Δ mood. Mood final forces a slight change in my face caused by elongated sarcomere distance. The direct relationship between the sarcomere and my stomach fear increases exponentially. Off the charts. Extrapolate That. Tell me the future. Tell me what will happen so that we don’t have to dabble in the present. Unclear and fuzzy, yet fresh and exciting.

But tonight I am going to do what a single man does, because I can.

Port-Au-Prince, Haiti

Cardiovascular control of the heart.

Vagus Nerve

The Pacemaker. The beat. The thermostat of the rhythm of the Heart. Thud Thud.

Letters organize into words. Words into thoughts. Neurotransmitters of ideas. A collection of cells and stream of tissue mobilized and electrified like the protruding villi of my hands, the phalanges, the vessels of touch.