Preventing Illness

Christofer Toumazou at age 23, was accepted for a postdoctoral position in the university, beginning a career from there which would see him create a combined digital and analogue mobile phone, an artificial pancreas for type one diabetics and a wireless heart monitor, among other inventions.

It is his latest creation (above), however, which has sparked the most interest and last month earned him a European inventor award. Using a small silicon microchip in a USB, a 'lab on a chip' as it has been coined, DNA data can be analyzed within minutes and outside a laboratory.

The new technology is aimed at identifying predispositions for hereditary diseases like diabetes and prescribing the exact right dosage for medications, cutting down on the cost of current DNA testing machines.

"My dream was to have a handheld consumer device with … a little USB stick that could look at rapidly screening for genetic mutations of particular diseases, whether it is a predisposition to type two diabetes [or] whether to a type of breast cancer," said Toumazou in his office in the Institute of Biomedical Engineering.

The new DNA analysis method is the latest installment in a far from traditional career path for the Greek-Cypriot. 

Having left school in Cheltenham at 16 with a "few CSEs", the most typical route for him to follow would have been in the family catering business until he became inspired by an aunt's husband who was an engineer and from there developed an interest in electrical engineering.

Encouraged to do a one year radio and electronics certificate – when the "whole Greek Cypriot contingent of Cheltenham turned up" on his first day – he says he found the environment in which he wanted to thrive and went on to a two year general engineering course, a degree at the then Oxford polytechnic and later a PhD. By 23, he had applied for a postdoctoral position at Imperial College and was offered it the same day.

The position involved working with industry to reduce the size of a satellite phone at a time when his interest was in analogue – speech, sound and vision – electronics. 

Thaksin Shinawatra, the former Thai prime minister who then ran a mobile phone operator, asked him to make a combined digital and analogue mobile phone in the 90s, which led to the establishment of Toumaz Technology, a commercial spin-off.

Helping to Avoid Cancer

CDC attributes the recent rise in syphilis primarily to gay and bisexual men; they have also released official guidelines for the use of PrEP to prevent the spread of HIVeven though some worry it could drive down condom use. Additionally, an editorial was just published which pushes for more gay and bisexual men to receive the HPV vaccine to prevent HPV associated cancers.

This new article outlines barriers to care for LGBT people with cancer, including the need for better cultural competency and policy changes, that were presented by expert speakers at the Cancer in LGBT Communities Conference in January, co-organized by the Network for LGBT Health Equity, the National LGBT Cancer Network, Memorial Sloan-Kettering Cancer Center and Callen-Lorde.

Right after HRC released a study showing most people are closeted in the workplace, we see this interesting analysis showing that psychological flexibility may be key to being healthy and out at work. Nicely, some employers are listening, Trades Union Congress in England just published a new guide to bolstering the mental health of LGBT employees in the workplace.

A study of trans men who presented at Fenway Health for sexual transmitted disease screening found high number of mental health issues (61%) and regular alcohol use (65%). Authors conclude trans men have a health vulnerabilities which may lead to sexual risk behaviors.

Trans Advocates in New York City took the stage in the HxRefractored Conference this week to protest lack of access to trans care through Medicaid. The NYC protests are just one of several recent health stories demonstrating the need for the May 17th International Day Against Homophobia. 

Read other recent news about health barriers for incarcerated trans people here and here.

ALERT:

Vaginas Can Now Be Implanted  

Four women have had new vaginas grown in the laboratory and implanted by doctors in the US.

A tissue sample and a biodegradable scaffold were used to grow vaginas in the right size and shape for each woman as well as being a tissue match.

They all reported normal levels of "desire, arousal, lubrication, orgasm, satisfaction" and painless intercourse.

Experts said the study, published in the Lancet, was the latest example of the power of regenerative medicine.

In each woman the vagina did not form properly while they were still inside their mother's womb, a condition known as vaginal aplasia.

Current treatments can involve surgically creating a cavity, which is then lined with skin grafts or parts of the intestine.

Doctors at Wake Forest Baptist Medical Centre in North Carolina used pioneering technology to build vaginas for the four women who were all in their teenage years at the time.

Scans of the pelvic region were used to design a tube-like 3D-scaffold for each patient.

A small tissue biopsy was taken from the poorly developed vulva and grown to create a large batch of cells in the laboratory.

Muscle cells were attached to the outside of the scaffold and vaginal-lining cells to the inside.

The vaginas were carefully grown in a bioreactor until they were suitable to be surgically implanted into the patients.

One of the women with an implanted vagina, who wished to keep her name anonymous, said: "I believe in the beginning when you find out you feel different.

"I mean while you are living the process, you are seeing the possibilities you have and all the changes you'll go through.

"Truly I feel very fortunate because I have a normal life, completely normal."

All the women reported normal sexual function.

Vaginal aplasia can lead to other abnormalities in the reproductive organs, but in two of the women the vagina was connected to the uterus.

There have been no pregnancies, but for those women it is theoretically possible.

Globally Growing Cancer

New cancer cases expected to grow from 14 million a year in 2012 to 25 million, with biggest burden in low- and middle-income countries.

Cancer cases worldwide are predicted to increase by 70% over the next two decades, from 14 million in 2012 to 25 million new cases a year, according to the World Health Organization.

The latest World Cancer Report says it is implausible to think we can treat our way out of the disease and that the focus must now be on preventing new cases. Even the richest countries will struggle to cope with the spiraling costs of treatment and care for patients, and the lower income countries, where numbers are expected to be highest, are ill-equipped for the burden to come.

The incidence of cancer globally has increased in just four years from 12.7 million in 2008 to 14.1 million new cases in 2012, when there were 8.2 million deaths. Over the next 20 years, it is expected to hit 25 million a year – a 70% increase.

The biggest burden will be in low- and middle-income countries. They are hit by two types of cancers – those triggered by infections, such as cervical cancers, which are still very prevalent in poorer countries that don't have screening, let alone the HPV vaccine, and increasingly cancers associated with more affluent lifestyles "with increasing use of tobacco, consumption of alcohol and highly processed foods and lack of physical activity", writes the World Health Organisation director general, Margaret Chan, in an introduction to the report.

Lung cancer is the most commonly diagnosed among men (16.7% of cases) and the biggest killer (23.6% of deaths). Breast cancer is the most common diagnosis in women (25.2%) and caused 14.7% of deaths, which is a drop and only just exceeds lung cancer deaths in women (13.8%). 

Bowel, prostate and stomach cancer are the other most common diagnoses.

"Despite exciting advances, the report shows that we cannot treat our way out if the cancer problem," said Dr. Christopher Wild, director if the International Agency for Research on Cancer and joint author of the report.

"More commitment to prevention and early detection is desperately needed in order to complement improved treatments and address the alarming rise in cancer burden globally."

Indian Giver

A British woman said she wishes she could reclaim her donated kidney from her allegedly unfaithful husband

Samantha Lamb, 41, of Ivybridge, England, said she and Andy, 45, married in 2007 and she gave him a kidney a few years later when he became ill and needed a transplant, the Mirror's Sunday People tabloid reported.

Lamb said the marriage broke apart a few years later when she suspected he was having an affair with her friend and the other woman admitted to the infidelity.

"I can't believe he now has a second chance to live to see his grandchildren grow up," Lamb said. "I would definitely go through the operation again -- but I wouldn't give the kidney to him. I hate him. If I could I'd take it back and give it someone else. Obviously I don't want people to be put off putting their names on the organ donor list. But all I want from him is his name on the divorce papers."

Andy Lamb said he was never unfaithful to Samantha.

"I did walk out on Samantha after she'd donated her kidney, but I wasn't unfaithful," he said. "I never wanted her to donate her kidney because it was a big risk. But she insisted and I'll always owe her my life.

"I loved her but our relationship wasn't working. We had big rows and her family never liked me," he said. "Despite what Samantha believes, I've never been with her friend. I just helped train her dog."

Seven Week Erection

A cyclist needed medical intervention at an Irish hospital because an injury he suffered caused his penis to remain erect for nearly two months.

The unnamed bicyclist sustained an injury on the crossbar of his mountain bike that interfered with the blood flow to his penis.

A medical report quoted in the Irish Examiner said the biker’s pain and bruising settled within days, but that he sustained ongoing “high-flow” priapism “with rigid erection”.

Priapism is a potentially painful medical condition in which the erect penis does not return to its flaccid state, despite the absence of both physical and psychological stimulation, within four hours. 

Priapism is considered a medical emergency, which should receive proper treatment by a qualified medical practitioner.

There are two types of priapism: low-flow and high-flow; 80% to 90% of clinically presented priapisms are low flow disorders. Low-flow involves the blood not adequately returning to the body from the organ. High-flow involves a short-circuit of the vascular system partway along the organ. 

Treatment is different for each type. Early treatment can be beneficial for a functional recovery.

Not all sources give four hours as the guideline for priapism occurring: 

"The duration time of a normal erection before it is classifiable as priapism is still controversial. 

Ongoing penile erections for more than 6 hours can be classified as priapism."

The name comes from the Greek god Priapus, a fertility god often represented with a disproportionately large and permanent erection.

After suffering in silence for five weeks, he finally sought medical attention.

A hospital report said the initial examination “revealed no signs of injury, but penis was erect”.

Doctors first tried “manual compression” which would work for a short time, but then the penis would become erect again.

Then they applied a pressure dressing that was in place for two weeks. But once the pressure was removed there was an immediate return of the erection.

Finally doctors inserted gel foam and four tiny platinum coils at an abnormal connection between an artery and a vein that supplied blood to the man’s penis.

This successfully reduced the blood supply to the penis, ending the erection.  One of the medical technicians said, “We were very happy with the outcome.”

The CDC notes that bicycle parts manufacturers are developing saddles that ease pressure on the genitals.

Let's Have Hernia Surgery

Researchers in Oxford have developed a degradable implant which they say has huge potential to improve surgical success rates.

The protective patch, which wraps round soft tissue repairs, will be trialed in patients with shoulder injuries.

It is hoped in time this approach could help patients with other conditions including arthritis, hernias and heart defects.

The implant has been developed using a mix of modern and ancient technology.

Kevin Senior (above) experiences pain every time he lifts his right arm. He has torn the tendons in his shoulder. Mr. Senior, who is 59, is a plumbing engineer, so this gives him serious difficulties in his work.

Even combing his hair or shaving causes him problems.

He is looking forward to having an operation next year at Nuffield Orthopedic Hospital in Oxford.

"It's very frustrating but obviously you've got to do the best you can. Hopefully when it's repaired I'll be able to do everything, but as it stands now, you just struggle on."

There are 10,000 of these shoulder repair operations carried out each year in England and Wales. The figure has risen by 500% in the last decade. But one in four procedures is not successful, because the tendon tears again.

The surgeon who will operate on Kevin Senior's shoulder, Professor Andrew Carr, has led a research project to improve the success rate and ensure a quicker recovery. This collaboration between the university and the hospital trust helps move ideas quickly from the lab to the clinic.

Professor Carr's team have developed a protective patch - an implant which wraps around the surgical repair, like a splint.

One side is made of resilient woven material, to help it withstand the stresses of movement after surgery.

The other side is made of thread spun a hundred times finer than human hair.

Bio-printing Heart

A team of cardiovascular scientists has announced it will be able to 3D print a whole heart from the recipients' own cells within a decade.

Stuart K Williams is heading up the hugely ambitious project as executive and scientific director of the Cardiovascular Innovation Institute at the University of Louisville.

Throughout his prestigious career spanning four decades he has focused on researching surgical devices and bioengineering, and the idea for printing the heart whole from scratch was inspired by the work of one of the pioneers in both these fields -- Charles Lindbergh.

Lindbergh might be best known for flying solo across the Atlantic and for the Crime of the Century (when his infant son was kidnapped and murdered) but he also created a glass perfusion pump with Alexia Carrel that would keep the human heart alive outside the body, paving the way for heart surgery. The pair also discussed regenerative medicine in their book The Culture of Organs.

"For bio-printing it is the end of the beginning as bio-printed structures are now under intense study by biologists" Stuart K Williams, Cardiovascular Innovation Institute

"Funding is very limited as this is a new area. But as bio-printing successes occur the interest will increase and then funding -- so many breakthroughs have occurred in this way with a new untested idea that is moved forward with limited resources. For bio-printing it is the end of the beginning as bio-printed structures are now under intense study by biologists."

Williams says he and his team of more than 20 have already bioengineered a coronary artery and printed the smallest blood vessels in the heart used in microcirculation. The team has also worked on other methods of bioengineering tissue, including electro-spinning for the creation of large blood vessel scaffolds that can then be joined with bio-printed micro-vessels.

But why print the parts, when you can print the whole in one go? We shouldn't just be able to repair the heart using bioengineering, but replace it.

The Cardiovascular Innovation Institute is now developing 3D printers for the job with a team of engineers and vascular biologists -- "if you do not understand the biology, you solve only half the problem" explains Williams.

Though for now those printers are focusing on replicating the parts, the plan is to print the whole in one go in just three hours, with a further week needed for it to mature outside of the body. Certain parts will need to be printed and assembled beforehand, including the valves and the biggest blood vessels. "Final construction will then be achieved by bio-printing and strategic placement of the valves and big vessels," says Williams, who asserts that they are "on schedule" to build the heart within the decade marker.

"Dare I say the heart is one of the easiest to bio-print? It's just a pump with tubes you need to connect"  Stuart K Williams, Cardiovascular Innovation Institute 

Nude Therapy

A Lake Worth, Fla., doctor (right) who treated a depressed patient by disrobing, binding, whipping and beating her is now in hot water for his twisted "punishment therapy."

Dr. David Simon apologized profusely to the Florida Board of Osteopathic Medicine,which is considering revoking his license, WPFB reports. Simon wasn't arrested or charged with any crime, but he admitted to having an unusual and sexual relationship with a then 38-year-old patient.

The patient told detectives that Simon said "punishment therapy" -- using blindfolds, whips and phallic objects on her for hours on end -- would help remedy her depression. She reportedly said she "didn't like" the therapy, which took place after normal work hours, but consented to the acts with Simon monthly for a year.

She reported the acts to deputies in December 2011.

During the sessions, Simon would regularly choke and tie up the naked woman, the Sun-Sentinel reports. She told detectives that she performed sexual acts on Simon as a "thank you" for the therapy.

The allegations came to light Friday when the board turned down Simon's settlement, which would bar him from practice for two years and slap him with a $10,000 fine. The board said the charges were too serious to settle.

"He's deeply embarrassed," Simon's attorney, David Spencer, told WPBF. "This was a consensual relationship with an adult woman. However, the Board of Health is clear that doctors can't have a sexual relationship with a patient. That's why we worked out the settlement."

WPBF also reported that Simon was flagged for sexual harassment in 2010, when he allegedly rubbed a 24-year-old woman's back and buttocks after a gynecological exam. 

He allegedly said at the time, "I think you need to be punished for being a bad girl. It seems you really need to be punished."

Simon has practiced in the area for 28 years and is married, Health News Florida reports.

In The Head

Would 

you:

• like to surf the Internet, make a phone call or send a text message using only your brain? 
• like to “download” the content of a 500 page book into your memory in less than a second? 
• like to have extremely advanced nanobots constantly crawling around in your body monitoring it for disease? 
• like to be able to instantly access the collective knowledge base of humanity wherever you are? 

All of that may sound like science fiction, but these are technologies that some of the most powerful high tech firms in the world actually believe are achievable by the year 2020. 

However, with all of the potential “benefits” that such technology could bring, there is also the potential for great tyranny. 

What do you think that the governments of the world could do if almost everyone had a mind reading brain implant that was connected to the Internet? 

Could those implants be used to control and manipulate us? 

For now, most of the scientists that are working on brain implant technology do not seem to be too worried about those kinds of concerns.  Instead, they are pressing ahead into realms that were once considered to be impossible.

Right now, there are approximately 100,000 people around the world that have implants in their brains.  Most of those are for medical reasons.

But this is just the beginning.  According to the Boston Globe, the U.S. government plans “to spend more than $70 million over five years to jump to the next level of brain implants”.

This new project is being called the Systems-Based Neurotechnology for Emerging Therapies (SUBNETS), and the goal is to be able to monitor the “mental health” of soldiers and veterans.  The following is how a recent CNET article described SUBNETS…

SUBNETS is inspired by Deep Brain Stimulation (DBS), a surgical treatment that involves implanting a brain pacemaker in the patient’s skull to interfere with brain activity to help with symptoms of diseases like epilepsy and Parkinson’s. DARPA’s device will be similar, but rather than targeting one specific symptom, it will be able to monitor and analyze data in real time and issue a specific intervention according to brain activity.

This kind of technology is being developed by the private sector as well.  In fact, according to Scientific American scientists are becoming increasingly excited about how brain implants can be used to “reboot” the brains of people with depression…

Psychological depression is more than an emotional state. Good evidence for that comes from emerging new uses of a technology already widely prescribed for Parkinson’s patients. The more neurologists and surgeons learn about the aptly named deep brain stimulation, the more they are convinced that the currents from the technology’s implanted electrodes can literally reboot brain circuits involved with the mood disorder.

The NeuroPace RNS is the first implant to listen to brain waves and autonomously decide when to apply a therapy to prevent an epileptic seizure. It was developed by a company with a staff of less than 90 people, only about 30 on the core electronic, mechanical, and software engineering teams.

A different team of researchers has discovered that it can stimulate the repair of brain tissue in rats using brain implants…

Stroke and Parkinson’s disease patients may benefit from a controversial experiment that implanted microchips into lab rats. Scientists say the tests produced effective results in brain damage research.

Rats showed motor function in formerly damaged gray matter after a neural microchip was implanted under the rat’s skull and electrodes were transferred to the rat’s brain. 

Without the microchip, rats with damaged brain tissue did not have motor function. Both strokes and Parkinson’s can cause permanent neurological damage to brain tissue, so this scientific research brings hope.

But, 

what else 

might 

it bring 

as well?

Solving the Riddle

Researchers seeking weapons against HIV have solved a molecular riddle about how the pathogen docks with immune system cells to unleash its viral mayhem.

Their computer-generated images of the molecules, which are 185,000 times smaller than the width of a human hair, offer researchers promising avenues for developing a drug that might impede HIV's cellular invasion, according to a study published online Thursday in the journal Science Express.

“We don’t have the whole scenario of what happens when HIV enters a cell, but this is going to be a major jigsaw-puzzle piece,” said Dr. P.J. Klasse, a virologist at Weill Cornell Medical College in New York, who was not part of the research team. 

“These authors have really accomplished a lot in explaining how the virus chooses between different co-receptors.”

The researchers, based at the Shanghai Institute of Materia Medica and the Scripps Research Institute in La Jolla, Calif., sought to illustrate how proteins on the surface of the virus help it dock with the membrane of a victim's helper T-cells, a kind of white blood cell.

To do so, the immunodeficiency virus takes advantage of cell receptors, which are crucial to thousands of genetic signaling functions in living things from amoebas to animals. These unseen facilitators are largely responsible for how the body pulls off unique and complex tricks such as vision, smell and the firing of neurons. 

They also are central to inflammatory responses that can be the root of chronic disease.

HIV was known to take advantage of two such helpers in a class known as chemokine receptors. A member of the Shanghai-based team had helped solve the structure of one, CXCR4, while at Scripps, and researchers had developed a drug to impede the second co-receptor, CCR5, that is more commonly used by strains of HIV1. 

Together, the receptors trigger a process that allows the virus' membrane to fuse with the membrane of human T-helper lymphocytes and other vulnerable cells.

The Shanghai team used a crystallized form of the CCR5 receptor, bound to the blocking drug Maraviroc, to determine the receptor's structure. That enabled them to compare it with the structure of the other receptor to discern subtle differences.

“Our previous success … helped us to better understand the protein behavior of the more challenging CCR5 receptor,” lead researcher Beili Wu said in written remarks.

The images published Thursday reveal subtle differences in the “binding pockets” of the receptors. They also offer details about how Maraviroc (marketed as Selzentry) alters the shape of the receptor, indirectly blocking HIV’s invasion. 

The breakthrough could offer ways to improve the drug's effect or develop new pathways to defeating the virus.

“If you could unleash the trigger of the virus before it reaches the cell, you would for all practical purposes irreversibly inactivate, or to use more drastic language, kill the virus,” Klasse said.

Under the Knife

An experimental surgical knife (left) can help surgeons make sure they've removed all the cancerous tissue, British doctors have reported; and, as a former and current cancer patient, this is very good news to hear for this writer.

Surgeons typically use knives that vaporize tumors as they cut, producing a sharp-smelling smoke. The new knife analyzes the smoke and can instantly signal whether the tissue is cancerous or healthy. 

This writer was recently  diagnosed with an Acral Lentiginous Melanoma on my left foot which was surgically removed but I have to wait for several days for my Surgical Oncologist to receive word from Pathology that he had gotten it all; otherwise, I would have been scheduled for another surgery.  This waiting around was mentally exhausting for me.

Dr. Zoltan Takats of Imperial College London suspected the smoke produced during cancer surgery might contain some important cancer clues. So he designed a "smart" knife hooked up to a refrigerator-sized mass spectrometry device on wheels that analyzes the smoke from cauterizing tissue.

The smoke picked up by the smart knife is compared to a library of smoke "signatures" from cancerous and non-cancerous tissues, information appears on a monitor: green means the tissue is healthy, red means cancerous and yellow means unidentifiable.

To make sure they've removed the tumor, surgeons now send samples to a laboratory while the patient remains on the operating table. It can take about 30 minutes to get an answer in the best hospitals, but even then doctors cannot be entirely sure, so they often remove a bit more tissue than they think is strictly necessary. If some cancerous cells remain, patients may need to have another surgery or undergo chemotherapy or radiation treatment.

"(The new knife) looks fabulous," said Dr. Emma King, a head and neck cancer surgeon at Cancer Research U.K., who was not connected to the project. The smoke contains broken-up bits of tumor tissue and "it makes sense to look at it more carefully," she said.

The new knife and its accompanying machines were made for about >250,000 ($380,486) but scientists said the price tag would likely drop if the technology is commercialized.

The most common treatment for cancers involving solid tumors is removing them in surgery. In the U.K., one in five breast cancer patients who have surgery will need further operations to get rid of the tumor entirely.

Not Wanting to Eat Healthy

School officials in Carmel Clay, Ind., said they lost $300,000 last school year because students are rejecting the healthy menu changes brought on by First Lady Michelle Obama’s federal lunch regulations.

“I’ve had a lot of complaints, especially with the little guys,” Linda Wireman, a food service director for North White School Corp., told JCOnline. “They get a three-quarters cup of vegetables, but if it’s something they don’t like, it goes down the garbage disposal. So there are a lot of complaints they’re going home hungry.”

 

Amy Anderson, the food service director for the school district, said the rules made her feel less like an educator and more like a “food cop.” The changes have even made her consider retiring early.

Lori Shofroth, Tippecanoe School Corp.’s food service director, said many students are throwing food away, putting a dent in the district’s budget.

“They’re teaching our kids with this meal pattern that it’s OK to throw away,” she told JCOnline. “We did a waste study on three different schools, and there was a huge amount of waste. That was just with produce, fruit or vegetables or milk.”

Other students don’t eat the lunches at all, resulting in a $300,000 loss for the district.

“I’ve got kids who can stop at Panera and pick up a sandwich that meets none of these criteria. I’m not maybe your typical school district, and they’re assuming that every student doesn’t have access to food, and that’s incorrect in this community,” Amy Anderson told the paper. “Our kids can just wait and just hop in their BMWs and go to McDonald’s, which they’re rebuilding, making it bigger.”

As reported by the Harvard School of Public Health  Childhood obesity has been called “one of the most serious public health challenges of the 21st century,” and with good reason.

Obesity can harm nearly every system in a child’s body—heart and lungs, muscles and bones, kidneys and digestive tract, as well as the hormones that control blood sugar and puberty—and can also take a heavy social and emotional toll. (2) What’s worse, youth who are overweight or obese have substantially higher odds of remaining overweight or obese into adulthood, (3) increasing their risk of disease and disability later in life.