Interesting article about President Obama’s science advisors.
http://www.nytimes.com/2009/02/24/science/24tier.html?_r=1&8dpc
Downpayment on Healthcare February 20, 2009
The American College of Physicians recently published an article about the impact of the recent economic stimulus package on our current health care system. It’s short, take a read.
Yours In Good Health
African Americans and Increase Death Rate After Surgery February 18, 2009
The researchers at Center for Outcomes Research, The Children’s Hospital of Philadelphia conducted a study to review the reasons for improved survival after surgery in teaching hospitals had unexpected results. It is generally acknowledged that survival after surgery is higher at teaching hospitals (hospitals with medical students and physicians in training). Teaching hospitals are generally felt to provide better care because they are larger, generally have advance technology, greater volume and better nursing staff. Using medicare claims data the researchers were able to show that improved survival is because of lower mortality after complications (better failure to rescue) and generally not because of fewer complications. However, the high survival and failure to rescue results seen in white patients were not seen in black patients. It appears that black patients fare about equally well in teaching and nonteaching hospitals, whereas white patients have significantly better risk-adjusted mortality and failure to rescue at teaching hospitals than at nonteaching hospitals. The explaination for these findings are unclear.
In an earlier study by the same researchers found racial differences in the length of surgery for comparable procedures and income. Black medicare patients had surgery that took 29 minutes longer than whites. The authors suggested that Blacks tended to receive their surgeries from hospitals with longer procedure times.
http://archsurg.ama-assn.org/cgi/content/full/144/2/113
Yours In Good Health
HIV Microbocides February 16, 2009
The article linked to this post is the quick and dirty on the state of microbicide research in 2009. There is still alot of work to be done. It’s a quick read.
http://www.nytimes.com/2009/02/17/health/17glob.html?ref=health
Yours in Good Health
CROI 2009 – Day 2 February 10, 2009
Day 2 Plenary session was presented by Drs. Elizabeth Corbett and Daniel Douek. Dr. Corbett reviewed the interaction between TB and HIV infections and the need for HIV and TB interventions to be combined at a clinical and community level. She recommended home based care for resource poor settings; periodic access to TB diagnostics (smear collections) outside of the clinic; community wide INH (TB) treatment in miners; and strengthening the relationship between HIV and TB.
In Dr. Doucek lecture on Immune effects at HIV infected mucosal surfaces he eloquently reveiwed the relationship between CD4 T cell loss, mucosal barrier integrity, systemic immune activation and HIV/SIV disease progression. HIV infected individuals have leaky guts - increased gut permeability. Dr. Doucek outlined the difference between non-pathogenic and pathogenic primates (humans) response to HIV infection. The major difference is pathogenic primates do not downregulate the acute immune activation and nonpathogenic primates do. The immune activation phase is the most important phase for progression to AIDS. If there is one plenary to review on immune function it would be this lecture, he lays out the information in a simple manner that is understandable to nonimmunologist. The combination of Dr. Siliciano’s lecture about latent reservoirs and Dr. Douek’s lecture gives us a good understanding of why it has been such a difficult road to a cure for HIV.
Other very note worthy presentations for the day were in the area of HIV shedding in the genital track, aging and metabolic syndromes as risk factors for neurologic disorders, Hepatitis B & C Infections, Prevention and Treatment of Serious Malignancies.
Specific points from oral presentations:
- Delay in therapy in older adults is associated with higher mortality (10 year intervals)
- Delay of treatement in patients below 350 increase risk of AIDS and death was conclused in two observation studies.
- The cure of Hepatitis C seems to require triple therapy and may be accomplished without the use of interferon.
- Hepatitis cure may first require the clearing of infected cells and then the stopping of replication of virus.
- Increasing studies of the cognitive function of older adults (>50) required.
- The microbocide gel PRO2000 was shown to have a 30% level of protection in transmission of HIV infection but a 78% reduction in frequent gel users. It is not effective against other STDs or as a contraceptive (11% pregnancy rate).
Yours In Good Health
Retrovirus Conference – CROI 2009 February 9, 2009
Over the next 3 days the world scientist and clinicians will gather in Montreal, CA to present and discuss various HIV/AIDS research. The Opening Ceremony featured:
- Dr. Siliciano discussion of HIV reservoirs in people living with HIV. The latent reservoirs remain stable dispite highly active antiretroviral therapy (HAART). He believes that patients that are adherent to HAART is as good as it gets when patients are adherent to medications. We have to find a way to get to rid the reservoirs of HIV inorder to eradicate the virus.
- Oliver Mtukudzi, the Zimbabwean musician activist performed with his band The Black Spirits. Oliver lost his brother to HIV/AIDS and has used his music to provide prevention messages. The Black Spirits is a blend of soul, chimurenga, South African mbaqanga, Zimbawean pop, and the traditional kateke drumming of the Korekore clan. It was great!!
- The 3rd N’Galy-Mann Lecture was presented by Glenda Gray and James McIntyre from South Africa. The lecture was named after Drs. Bosenge Ngaly and Jonathan Mann, whom both died tragically about 10 years apart in a car and plane accident. The HIV epidemic has devastated South Africa; 5.7 million people are living with HIV and 50% of all hospital admissions are from HIV. Four thousand teachers die every year due to HIV. One in every 5 nurses are HIV positive. It has been stated that the country “will run out of people before we run out of money”. There is hope however 45,000 people have received treatment thru PEPFAR funds.
For additional information please see ther following:
http://www.retroconference.org/2009/data/files/webcast.htm
Yours in Good Health
National Black HIV Awareness Day February 7, 2009
February 7 is National Black HIV/AIDS Awareness Day, which seeks to increase awareness of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) among blacks living in the United States. In 2006, Blacks accounted for approximately 12% of the adolescent and adult U.S. population but 46% of people living with HIV. HIV incidence reports show that Blacks had the highest rates of new infections of any racial/ethnic group. Among black females, high-risk heterosexual contact accounted for 83% of the new infections. Among black males, male-to-male sexual contact accounted for 63% of the new infections.
Please speak to yourself and a loved one about the various high risk behaviors that can lead to transmit HIV. HIV can be transmitted via sex and blood to blood transfer (cuts, sharing of needles, etc).
For addtional information about HIV, please review the following:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5804a1.htm?s_cid=mm5804a1_e
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5804a2.htm?s_cid=mm5804a2_e
Yours In Good Health
Super Bowl February 1, 2009
Okay, I have to admit that since Plaxico Burress shot the Giants out of the playoffs this year I have not been the fanatic NFL fan that I was last year. I have watched the playoff games and do have favorite players and coaches but not necessary a favorite team. I am looking forward to Super bowl on sunday. I pick the Pittsburgh Steelers.
Last year amongst my many NFL posts, I wrote about the NFL players and concussions based on the fitness of their helmets. On tuesday, January 26th, Boston University held a news conference in Tampa to announce that Tom McHale, former NFL lineman 1987 – 1995 had Chronic Traumatic Encephalopathy (CTE). Tom McHale died May 2008 at the age of 45. CTE is a condition that leads to lack of insight, poor judgement, decreased concentration and attention, inability to multitask and various memory difficulty. Those affected by CTE can develop dementia in their 40’s and 50’s. CTE is believed to be caused by repetitive head trauma and has heightened the argument about the proper prevention and treatment brain treatment in football. The condition is generally identified after death. To date 6 out of 6 deceased NFL players aged 36 – 50 have been found to have CTE.
The NFL pamphet continues not to acknownledge the cumulative effects of multiple concussions. NFL stated that they are waiting to review the CTE cases in a peer reviewed journal.
Yours In Good Health
http://www.nytimes.com/2009/01/28/sports/football/28brain.html?ref=football
