United States

HIV virus returns in two cured patients: US doctor

Two patients previously thought to be ‘cured’ of HIV after undergoing bone marrow transplants are now seeing the return of the virus in their blood, a US doctor has revealed.

Timothy Henrich, a physician-researcher at the Boston Brigham and Women’s Hospital, believed the re-emergence of the virus demonstrates that HIV reservoirs, latent cells carrying the virus, “is deeper and more persistent” than scientists had realised.

“The return of detectable levels of HIV in our patients is disappointing, but scientifically significant,” Henrich told Xinhua in a statement through e-mail.

“Through this research, we have discovered …that our current standards of probing for HIV may not be sufficient to inform us if long-term HIV remission is possible if anti-retroviral therapy is stopped,” he said.

The two HIV-positive patients, who do not want to be identified, received bone marrow transplants as part of treatment for Hodgkin’ s lymphoma, a cancer of the blood, one in 2008, the other in 2010.

HIV became undetectable in both patients approximately eight months after transplant. This year, during spring, they agreed to cease anti-retroviral therapy to test whether the transplant had eliminated the virus from their bodies.

In July, the researchers announced that the two have shown no signs of HIV after they were off anti-retroviral therapy for 15 weeks and seven weeks, respectively.

But in August, the researchers detected HIV in one of the patients, who then resumed taking medication. The other opted to stay off the medicine but last month, after 32 weeks with no HIV detected, signs of the virus re-emerged and the patient also resumed anti-retroviral therapy.

According to researchers, the virus is now suppressing as expected and they are both currently in good health.

Source: Business Standard

First full face transplant recipient in U.S.

A December 2010 photo shows Dallas Wiens prior to receiving a full face transplant. Wiens was injured in an electrical accident in Texas in 2008. Before his face transplant, he had surgeries to graft smooth skin over much of his face.

Dallas Wiens, first full face transplant recipient in U.S., grows comfortable in his new skin

‘My entire life is a miracle,’ said Wiens, 28, speaking at a conference of the Radiological Society of North America. Doctors are learning more from Wiens and other facial transplant patients about how the body evolves and adapts following the experimental surgeries.

The nation’s first full face transplant patient Dallas Wiens looks on during a news conference about new research into full facial transplants. Wiens was the first person in the U.S. to receive the surgery, in 2011.
The nation’s first full face transplant patients are growing into their new appearances—literally.

The nation's first full face transplant patient Dallas Wiens looks on during a news conference at McCormick Place in Chicago, Wednesday, Dec. 4, 2013. Despite still visible facial scars from the March 2011 surgery, Wiens looks and sounds like a recovered man. Medical imaging shows new blood vessel networks have formed, connecting transplanted skin with the patients' facial tissue, a finding that may help improve future face transplant surgeries, doctors announced Wednesday. (AP Photo/Paul Beaty)

Medical imaging shows new blood vessel networks have formed, connecting transplanted skin with the patients’ facial tissue, a finding that may help improve future face transplant surgeries, doctors announced Wednesday.

Dallas Wiens, the first U.S. man to get a full face transplant, is a remarkable example of that success. The 28-year-old Fort Worth man attended Wednesday’s annual meeting of the Radiological Society of North America with his new wife and golden retriever guide dog. Despite still visible facial scars from the March 2011 surgery, he looks and sounds like a recovered man.
A 2008 family photo shows Dallas Wiens with his daughter Scarlette prior to an electrical accident that disfigured his face.

“My entire life is a miracle,” Wiens said at a news conference.
His face was burned off in a 2008 painting accident at his church. He was on a cherry-picker lift when his head hit a high voltage wire.
After surgery, Wiens lived for two years with no facial features and just a two-inch slit for a mouth, until his transplant at Boston’s Brigham and Women’s Hospital.

A December 2010 photo shows Dallas Wiens prior to receiving a full face transplant. Wiens was injured in an electrical accident in Texas in 2008. Before his face transplant, he had surgeries to graft smooth skin over much of his face.

Dallas Wiens (r.) poses for a photo with his wife Jamie Nash and his guide dog Charlie. Despite still-visible facial scars from the March 2011 surgery, Wiens looks and sounds like a recovered man.Imaging studies on Wiens and two other full face transplants done at Brigham in 2011 show that a network of new blood vessels had formed just a year after the operations. A fourth full face transplant was performed at Brigham earlier this year.
The same thing typically happens with other transplants and it helps ensure their success by boosting blood flow to the donor tissue. But Brigham doctors say this is the first time it has happened with full face transplants.
The finding could eventually shorten the operating time for future face transplants, Brigham radiologist Dr. Frank Rybicki said. The operations can take up to 30 hours and include attaching spaghetti-thin arteries in the patients’ existing tissue to the donor face, but the findings suggest attaching only two facial or neck arteries instead of several is sufficient, he said.

Dr. Samir Mardini, a Mayo Clinic expert in reconstructive transplant surgery, said blood vessel reorganization occurs with other types of tissue transplants — doctors call it “neovascularization” and it helps ensure the tissue’s survival by improving blood flow.

“It’s interesting that they’ve shown it” with face transplants, but it’s not a surprise, Mardini said.
Face transplants, using cadaver donors, are still experimental. Fewer than 30 have been done since the first in 2005, said Dr. Branko Bojovich, a surgeon involved in a 2012 face transplant at the University of Maryland Medical Center.

He called the Boston team’s findings “very reassuring” for surgeons and for future patients.
“We’re assuming that these patients will hopefully go on to live productive and long lives,” Bojovich said.
Wiens’ life before the accident was troubled, and he says he misses nothing about it except possibly his eyesight.

Source: Daily news

Spike in U.S. measles cases shows disease still a threat: officials

The number of reported cases of measles in the United States this year is nearly three times the annual average, federal health officials said on Thursday, highlighting the continued threat of the disease 50 years after development of a vaccine.

There have been 175 measles cases so far in 2013, compared with the typical national average of about 60 cases a year, the Centers for Disease Control and Prevention said.

The federal health agency said home-grown measles were eliminated in the United States in 2000, but the disease has continued to be carried into the country from people who have traveled abroad.

The CDC said 172 of the 175 U.S. cases this year involved patients who were infected overseas or caught the disease from someone who had traveled internationally. The source of the other three infections remains unknown, the agency said.

“A measles outbreak anywhere is a risk everywhere,” CDC Director Tom Frieden said. “The steady arrival of measles in the United States is a constant reminder that deadly diseases are testing our health security every day.”

Earlier this year, the CDC linked 58 cases of measles in Brooklyn, New York, to an unvaccinated 17-year-old who had traveled to London. Twenty-three cases in North Carolina this year were tied to an unvaccinated resident who contracted the disease while on a three-month visit to India.

The CDC said 158,000 people die worldwide each year from measles.

The last measles death in the United States was in 2003, according to the agency. Before the country launched a widespread vaccination program in 1963, it had 450 to 500 measles deaths each year.

Measles is highly contagious and transmitted when an infected person breathes, coughs or sneezes. The disease can be spread even before an infected person has developed a rash from the virus.

The CDC recommends that children get two doses of vaccine for measles, mumps and rubella, starting at 12 to 15 months of age.

Increased vaccination worldwide and improving the ability of public health agencies to rapidly respond to outbreaks are keys to reducing measles and other diseases, the CDC said.

Source: Yahoo news

Real-Time Flu Forecast Predicts Outbreaks in Each US City

real-time-flu-forecast-predicts-outbreaks-each-city_1

Borrowing ideas from weather forecasting, researchers have developed a system to predict, weeks in advance, when a city will see the peak of its seasonal flu outbreak.

A reliable flu forecast could limit an outbreak by informing people and health officials so they can step up protective measures, the researchers said.

The researchers tested the model on 108 cities across the United States during the 2012-2013 flu season, and found they could accurately predict the timing of the influenza peak in more than 60 percent of the cities two to four weeks in advance, on average, according to the study, published today (Dec. 3) in the journal Nature Communications.
Source: Live Science

Flight Delayed Because of Tuberculosis Scare

Authorities are trying to determine whether a man who flew into Phoenix has tuberculosis, but any risk to passengers on his flight is extremely low even if it turns out he does have the infectious respiratory illness, public health officials said Monday.

About 70 passengers on the US Airways Express flight on Saturday from Austin, Texas, were briefly kept on the plane until after responders boarded and removed the man, who was asked to put on a medical mask.

Dr. Rebecca Sunenshine, medical director of the disease control division of the Maricopa County Department of Public Health, said the man is being tested to determine whether he has TB or any another illness.

Sunenshine said test results should be available within a week or so. The man is being tested at a hospital to speed up the process, not because of illness, she said.

Even if he has the disease, the short flight coupled with the fact that he wasn’t coughing or sneezing on the plane means risk of transmission is extremely low, Sunenshine said.

During her own hour-long interview with the man, “he did not cough at all,” Sunenshine said.

Sunenshine declined to provide details about the man but said he was put on no-fly status by the Centers for Disease Control and Prevention after the federal agency was contacted by health authorities in Texas.

Unfortunately the airline wasn’t notified until the flight was in the air, Sunenshine said.

Though a responder who went on the plane reportedly suggested that passengers get tested for TB, Sunenshine and a CDC physician familiar with the case said the other passengers don’t need to do anything.

The absence of coughing by the man made “it almost impossible to transmit TB to these passengers,” Sunenshine said.

“There’s really no risk in this situation,” said Dr. Francisco Alvarado-Ramy, a supervisory medical officer assigned with the CDC’s division of global migration and quarantine.

Along with the flight’s duration and the absence of coughing, there are other medical indicators that point to “very low to no concern,” Alvarado-Ramy said from San Juan, Puerto Rico.

Source: abc news

Ophthalmologist G. N. Rao honoured by US institute

Hyderabad, Nov 26 (IANS) The American Academy of Ophthalmology (AAO) honored eminent ophthalmologist Gullapalli N. Rao with its outstanding humanitarian service award, said a statement here Tuesday.

G. N. Rao is the founder and chairman of L.V. Prasad Eye Institute. This award was bestowed on him in recognition of the eye care delivery model he created with the institute and his contributions to prevention of blindness globally.

The award was presented to Rao on Nov 17, at the AAO’s annual meeting in New Orleans, said the statement.

LVPEI’s model of eye care, represented by a pyramid, emphasizes the creation of sustainable permanent facilities within communities, staffed and managed by locally trained human resources, and linked effectively with successively higher levels of care.

Rao was also earlier the recipient of international prevention of blindness award of the Academy.

The L.V. Prasad Eye Institute was established in 1986-87 here as a not-for-profit comprehensive eye care institution.

Source: Sify

New procedure allows jewelry to be implanted in the eye

A new procedure is allowing one New York woman to have a piece of platinum jewelry implanted in her eye, according to My Fox New York.

“It’s going to be a conversation maker,” Lucy Luckayanko, who received her eye implantation at Park Avenue Laser Vision in New York City, told My Fox New York. “I will be able to tell people. It will be unique. It will be sort of my unique factor.”

Dr. Emil Chynn, the medical director of Park Avenue Laser Vision, claims that the procedure is relatively safe.

“It’s a very thin piece of platinum that’s designed for insertion on the top of the eye. It’s not in the eye, so there’s no risk of blindness or anything at all,” Chynn told My Fox New York. “She could have a little bit of local bleeding. That could go away in a couple days or couple weeks. She could have an infection, but we’ll prevent that with antibiotics.”

Eye jewelry is not approved by the U.S. Food and Drug Administration (FDA), and the American Academy of Ophthalmology (AAO) is warning consumers about the dangers of the procedure.

In a statement to My Fox New York, the AAO said there isn’t “sufficient evidence to support the safety or therapeutic value of this procedure.” They urged consumers to “avoid placing in the eye any foreign body or material that is not approved by the FDA.”

Luckayanko said the reactions to her new eye jewelry have been mixed – with some of her friends saying she is crazy and others claiming it looks “super cool.”

Source: Fox News

How one woman recovered from a 20 year struggle with Munchausen syndrome

When Lindsay* was 11 years old, she started having the same dream every night.  After she fell asleep, she would envision herself suffering from fainting spells, as various people stood around her and worried about her health.

Then, when she woke up, she would be embarrassed about how good the fantasies made her feel.

“I just thought over it a lot,” Lindsay told FoxNews.com.  “…I’d get these dreams so often, and they were very pleasant.”

Her recurring dream eventually manifested into reality when Lindsay was 13 years old, after a strong allergic reaction caused her to repeatedly pass out.  In order to determine the source of her fainting spells, Lindsay was admitted to the hospital, where she stayed for two weeks.

And the longer she stayed in the hospital, the more she didn’t want to leave.

“I loved it in the hospital,” she said. “I just loved it.”

Once she was released, Lindsay wanted so badly to find her way back to this new place she had enjoyed so much.  So in spite of her good health, she started pretending to be sick with stomach pains, hoping this would allow her to return to that pleasant hospital setting.

Lindsay credits this experience with sparking the beginning of her long struggle with factitious disorder – more commonly referred to as Munchausen syndrome.   Craving that good feeling she had experienced while staying in the hospital, Lindsay eventually began researching and faking illnesses that she knew would keep her hospitalized for as long as possible.

Over the course of her lifetime, Lindsay would go on to feign more than 12 physical and mental illnesses – including extreme disorders like schizophrenia, multiple sclerosis and even epilepsy.

A student of illness

Although Lindsay’s first bout with Munchausen began when she was 13, she didn’t start faking full-blown illnesses until she was a young adult.

Then, at 24 years old, Lindsay gave birth to her first child and was admitted to a psychiatric ward after doctors suspected she was developing severe postpartum depression.

While in the hospital, those good feelings from her childhood returned.  The admission to the hospital gave her relief from the obligations of being a new parent – and she didn’t want that relief to end.

“I wanted to stay; I enjoyed it,” Lindsay said. “So I started faking the symptoms of other peoples’ illnesses… I didn’t really know what I was faking.  I was just mimicking other patients, like their illusions and hallucinations.”

Lindsay became a student of all the patients around her, closely studying their movements and their behaviors.  She would often spend one-on-one time with individuals in order to gain an accurate understanding of how their psychiatric illnesses manifested.  Once, she spent an entire afternoon with a highly disturbed person with schizophrenia who talked using a word salad – a confusing mixture of random words and phrases. Lindsay would eventually mimic the behavior she learned from him to get diagnosed with schizophrenia herself.

Over the next three years, Lindsay was in and out of the psychiatric hospital nine different times, mostly for depression but also for the other mental illnesses she had adopted.  Having had a taste of what it felt like to feign psychiatric disorders, she decided it was time to ramp up her performances – and start faking physical symptoms.

At first, Lindsay presented to different hospital emergency rooms with abdominal pains. However, she would become too scared to follow through with her charade and leave before she was admitted.

Then over time, she did more research on the disorders she wanted to mimic and became much more sophisticated at faking the different signs and symptoms.  She eventually became so adept at acting out these diseases, she would go on to be diagnosed with epilepsy, multiple sclerosis, Guillain-Barre syndrome, stroke, insulinoma, appendicitis and status epilepticus.

Throughout this time, Lindsay knew what she was doing was wrong – but she felt like she couldn’t stop.

“A million different things were going through my head,” Lindsay said.  “I felt terribly, terribly guilty, yet I would get the relief that I wanted – the attention, the feeling of control over my life that I didn’t have that I wanted.”

Over the next seven years, Lindsay would be admitted to 100 different hospitals.

Getting help

Though Lindsay found comfort in her Munchausen syndrome, the disorder wreaked havoc on both the personal and professional spheres of her life.  She was never able to hold down a steady job, as she would miss too many days of work while staying in the hospital.  And her repeated absences from her family inevitably took their toll: After eight years of marriage, her husband filed for divorce and gained full custody of their three children.

Additionally, Lindsay’s body was starting to wear out.  Her veins had become grievously scarred due to numerous IV injections, and she developed radiation sickness from all of the X-rays she had undergone.  Faking her various physical illnesses was becoming an extremely painful process.

Feeling utterly exhausted and alone, Lindsay decided it was time to get help for her problem.  Eventually, she read a book by Dr. Marc Feldman – one of the nation’s leading experts in Munchausen syndrome. In his book Patient or Pretender, Feldman claimed that “curing” a patient with factitious disorder was incredibly difficult – and nearly impossible.

“The classic thinking about patients with Munchausen is they have always been described as hopeless cases, and the best thing the doctor can do is run in the other direction,” Feldman, who is based in Birmingham, Ala., told FoxNews.com.  “Most don’t really entertain the idea of providing treatment.  Recovery is considered so rare, it’s publishable in the medical literature and considered a medical anomaly worthy of attention.”

However, this way of thinking frustrated Lindsay, who was determined to get her life back on track.  So she reached out to Feldman, and he invited her to come visit him in Alabama.

“She came to Birmingham and stayed for two and a half weeks, and we met every day,” Feldman said.  “It was kind of a crash course; we’d meet over coffee or lunch and talk for an hour and a half each day, and I learned a lot from her – and we’ve remained friends ever since.”

After hearing more about Lindsay and her story, Feldman asked her if she felt comfortable speaking about her illness to other medical professionals.  So the two met in Washington D.C., where Lindsay presented her tale to members of the American Psychiatric Association during their annual conference.

It marked one of the first times a Munchausen patient had spoken out about his or her disorder.

“I wanted to stand up there and say, ‘I do want help, and I have the capability to understand, so work with me,’” Lindsay said of her motivations.  “’Don’t be afraid and don’t run away.’”

The road to recovery

Though Lindsay was never Feldman’s patient, he helped put her in touch with a number of psychiatrists and other individuals who could potentially help her.  According to Feldman, Munchausen patients often have additional psychiatric disorders, such as depression or bipolar disorder, which go unnoticed – and by treating these underlying illnesses, individuals can then start to recover.

“Sometimes they get better with treatment,” Feldman said. “The fuel for the Munchausen tends to dissipate, and they find healthier ways to move on. Life changes occur, either through a spiritual element or social element, and they start to find that feigning illness gets in the way of the things the like to do.”

Eventually, Lindsay learned that she had an undiagnosed form of bipolar disorder, and she underwent three years of intensive psychotherapy to help alleviate her manic-depressive symptoms. And in turn, the treatment helped erase her Munchausen urges.

To help with her healing, Feldman also put Lindsay in touch with other Munchausen patients who were working towards recovery as well.  Lindsay noted that this was extremely beneficial to her own recovery process, just as Alcoholics Anonymous can be very helpful for those suffering from alcoholism.

“It’s a daily struggle,” Lindsay said. “…I look at it in terms of how a drug addict would talk about their cure.  It’s always there, and you have to work at it all the time.  It’s more like addiction.”

After a more than 20 year battle with Munchausen syndrome, Lindsay says she is now in recovery, having not feigned any illnesses for the past two years.  Thanks to her therapy, she was able to go back to school, procure a steady job, and reconnect with her children during their teenage years.  More than anything, she hopes that her story will serve as an example to patients and therapist alike that Munchausen syndrome can be cured – and that there is hope for those who feel alienated.

“Don’t let shame get in the way of talking it out with somebody,” Lindsay said.  “I was so ashamed of how ugly the thoughts were in the first place that I wouldn’t bring it up with anyone for years and years…I would tell people, not to feel ashamed of their own thoughts. Just talk about it with somebody.

Source: USA News

New York City bans tobacco sales to people under age 21

Mayor Bloomberg signed the legislation, which makes the city’s tobacco laws among the nations most stringent

Mayor Michael Bloomberg signed landmark legislation Tuesday banning the sale of tobacco products to anyone under the age of 21, making New York the first large city or state in the country to prohibit sales to young adults.

During a brief ceremony at City Hall, Bloomberg said rising the legal purchase age from 18 to 21 will help prevent young people from experimenting with tobacco at the age when they are most likely to become addicted. City health officials say 80 percent of smokers start before age 21.

The mayor, a former smoker, also signed companion legislation setting a minimum price for all cigarettes sold in the city to $10.50 per pack. That law also bans retailers from offering coupons, 2-for-1 specials or discounts.

In signing the bills, Bloomberg deflected criticism from some retailers that the measures would prove economically harmful and lead to job losses.

“This is an issue of whether we are going to kill people,” Bloomberg said. People who raise the economic argument, he said, “really ought to look in the mirror and be ashamed.”

The ban has limitations in its ability to stop young people from picking up the deadly habit. Teenagers can still possess tobacco legally. Kids will still be able to steal cigarettes from their parents, bum them from friends or buy them from the black-market dealers who are common in many neighborhoods.

But City Health Commissioner Thomas Farley said the idea is to make it more inconvenient for young people to get started, especially young teens who had previously had easy access to cigarettes through slightly older peers.

“Right now, an 18-year-old can buy for a 16-year-old,” he said. Once the law takes effect, in 180 days, Farley said, that 16-year-old would “have to find someone in college or out in the workforce.”

Source: Aljazeera America

US moves to ban trans fats in foods

US food safety officials have taken steps to ban the use of trans fats, saying they are a threat to health.

Trans fats, also known as partially hydrogenated oils, are no longer “generally recognised as safe”, said the Food and Drug Administration (FDA).

The regulator said a ban could prevent 7,000 deaths and 20,000 heart attacks in the US each year.

The FDA is opening a 60-day consultation period on the plan, which would gradually phase out trans fats.

“While consumption of potentially harmful artificial trans fat has declined over the last two decades in the United States, current intake remains a significant public health concern,” FDA Commissioner Margaret Hamburg said in a statement.

“The FDA’s action today is an important step toward protecting more Americans from the potential dangers of trans fat.”

‘Industrially produced ingredient’

If the agency’s plan is successful, the heart-clogging oils would be considered food additives and could not be used in food unless officially approved.

The ruling does not affect foods with naturally occurring trans fats, which are present in small amounts in certain meat and dairy products.

  • Some processed baked goods such as cakes, cookies, pies
  • Microwave popcorn, frozen pizza, some fast food
  • Margarine and other spreads, coffee creamer
  • Refrigerator dough products such as cinnamon rolls

Artificial trans fats are used both in processed food and in restaurants as a way to improve the shelf life or flavour of foods. The fats are created when hydrogen is added to vegetable oil, making it a solid.

Nutritionists have long criticised their use, saying they contribute to heart disease more than saturated fat.

Some companies have already phased out trans fats, prompted by new nutritional labels introduced in 2006 requiring it to be listed on food packaging.

New York City and some other local governments have also banned it.

But trans fats persist primarily in processed foods – including some microwave popcorns and frozen pizzas – and in restaurants that use the oils for frying.

According to the FDA, trans fat intake among Americans declined from 4.6g per day in 2003 to around 1g per day in 2012.

The American Heart Association said the FDA’s proposal was a step forward in the battle against heart disease.

“We commend the FDA for responding to the numerous concerns and evidence submitted over the years about the dangers of this industrially produced ingredient,” said its chief executive, Nancy Brown.

Outgoing New York Mayor Michael Bloomberg, who led the charge to ban trans fats in that city, said the FDA plan “deserves great credit”.

“The groundbreaking public health policies we have adopted here in New York City have become a model for the nation for one reason: they’ve worked,” he said.

Source: BBC News