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Study shows extent of brain damage from Zika infections

A report released on Tuesday shows in graphic detail the kind of damage Zika infections can do to the developing brain - damage that goes well beyond the devastating birth defect known as microcephaly, in which the baby's head is smaller than normal.

The current Zika outbreak was first detected last year in Brazil, where the virus has been linked to more than 1,800 cases of microcephaly, which can cause severe developmental problems.

Prior research has shown the Zika virus attacks neural progenitor cells - a type of stem cell that develops into different types of nerve or brain cells.

The latest research, published in the journal Radiology, draws from imaging and autopsy findings linked with confirmed Zika infections done on 17 infants and fetuses cared for at the Instituto de Pesquisa, in Campina Grande in the state of Paraiba in northeastern Brazil, where the infection has been especially severe.

The study also included reports on 28 fetuses or newborns with brain anomalies whose mothers were suspected of having Zika during pregnancy.

Nearly all babies in each group had ventriculomegaly, a condition in which the ventricles, or fluid-filled spaces in the brain, are enlarged.

While most of the fetuses had at least one exam showing abnormally small head circumference, suggesting they had microcephaly, three of the fetuses with ventriculomegaly had normal head circumference, but severe ventriculomegaly.

Nearly all of the fetuses or babies in the confirmed Zika group and nearly 80 percent of those in the presumed Zika group also had abnormalities of the corpus callosum - a large bundle of nerves that facilitates communication between the left and right hemispheres of the brain.

In all but one of the cases studied, the researchers found instances in which developing neurons did not travel to their proper destination in the brain.

In many cases, the babies' skulls seemed to have collapsed on themselves, with overlapping tissues and abnormal skin folds suggestive of a brain that had stopped growing.

"From an imaging standpoint, the abnormalities in the brain are very severe when compared to other congenital infections,” said study co-author Dr. Deborah Levine of Beth Israel Deaconess Medical Center and a radiology professor at Harvard Medical School.

As with other reports, the paper suggests that Zika does the most harm in the first trimester of pregnancy. The researchers plan to keep following the cases to see what impact prenatal Zika infections have on future brain development.

There is no vaccine or treatment for Zika, which is a close cousin of dengue and chikungunya and causes mild fever, rash and red eyes. An estimated 80 percent of people infected have no symptoms, making it difficult for pregnant women to know whether they have been infected.

Zika is carried by mosquitoes, which transmit the virus to humans. A small number of cases of sexual transmission have been reported in the United States and elsewhere.

source: Reuters Health
http://www.reuters.com/article/us-health-zika-imaging-idUSKCN10Y28A

Women with dense breasts may need annual mammograms

While most older women might not need breast cancer screening with mammography more often than every three years, some women with dense breasts may need mammograms every year, U.S. research suggests.

Among women aged 50 to 74, those without a high risk for breast cancer or dense breast tissue didn’t have an increase in breast cancer deaths if they went for mammography every three years instead of every two years.

But with dense breasts and a higher risk for these tumors, yearly mammograms were associated with fewer breast cancer deaths than screening every other year, researchers report in the Annals of Internal Medicine.

“Women at low risk and low breast density will experience more harms with little added benefit with annual and biennial screening compared to triennial screening, whereas women with dense breasts and high breast cancer risk may have added benefit from annual compared to biennial mammography,” lead study author Amy Trentham-Dietz of the University of Wisconsin-Madison said by email.

Doctors are conflicted about when and how often to recommend routine screening mammograms for women who don’t have lumps or discomfort in their breasts. Even though these exams can save lives, they can sometimes subject women to unnecessary and painful treatments that don’t find tumors or lower their risk of dying from cancer.

Last year, the American Cancer Society shifted its guidelines to encourage women to start annual screenings at 45 instead of 40 and to cut back to every other year once they turn 55.

The U.S. Preventive Services Task Force recommends mammograms every other year for women ages 50 to 74.

Worldwide, breast cancer is the most common malignancy in women. About one in nine women will eventually develop it, and the risk increases with age and when a woman’s mother, sister or daughter has been diagnosed with the disease.

Typically, if there is a suspicious area on a mammogram, women get additional imaging to rule out cancer, followed by a biopsy if more information is still needed to determine if the suspect cells are malignant. When the extra tests don’t find cancer, the mammogram result is considered a “false positive.”

For the current study, researchers estimated the odds of false positive mammograms, biopsies that didn’t find cancer and deaths averted based on age, cancer risk factors and breast density.

Compared with screening every two years, getting mammograms every three years could reduce false positives, biopsies and over-diagnosis without much effect on the number of cancer deaths averted for the majority of women – the ones with average cancer risk and lower breast density.

When women had a high risk of breast cancer, however, annual screening was better regardless of breast density, noted Dr. Christine Berg of Johns Hopkins University School of Medicine in Baltimore, who wrote an accompanying editorial.

However, “breast cancers are also more difficult to detect in dense breasts,” Berg added by email. “Therefore annual mammograms allow for comparison of subtle changes.”

The way women know if they have dense breasts is to get a mammogram - and density can change over time, noted Dr. Pamela DiPiro of the Dana Farber Cancer Institute in Boston.

“Annual mammography is a patient's best chance of detecting breast cancer early, with the known caveat that additional imaging, ultrasound or even a benign biopsy may be recommended,” DiPiro, who wasn’t involved in the study, said by email.

Still, the take-home message for women is complicated, said Dr. Kathryn Evers, director of mammography at Fox Chase Cancer Center in Philadelphia.

“There are numerous risk factors for breast cancer and women have different levels of comfort with the risks and benefits involved,” Evers, who wasn’t involved in the study, said by email.

“The fact that there are so many different recommendations regarding when and how often women should be screened points out that there are no definitive answers – women should talk to their doctors about what regimen will be best for them, taking all of these factors into account,” Evers added.

source: Reuters Health
http://www.reuters.com/article/us-health-mammography-dense-breasts-idUSKCN10X25W

PHL is losing war against diabetes

A TOP diabetes doctor said the Philippines is losing the war against diabetes and its complications.

Dr. Augusto D. Litonjua, president of the Philippine Center for Diabetes Education Foundation, Inc., that there are two major causes why this is: the increasing number of fast food joints and call centers.

He said call center work results in a wayward body rhythm that causes stress and internal confusion. The normal body clock has people awake in the day and asleep at night, but call center agents do the reverse since they have to process calls at night from the US and Europe where it is daytime. This reversal of the normal body clock stresses their bodies. “Stress precipitates diabetes,” said Dr. Litonjua. In addition, the lack of sleep causes people to overeat and choose the more convenient options: fast food.

“Fast foods are high in fat and are calorie-dense… Can we eliminate the fast food joints in the Philippines? No,” he said.

Dr. Litonjua was speaking at a press conference during Sweet Escape: Hataw Galaw on Aug. 12 at Quezon City’s Fisher Mall. The event, which promotes public awareness of diabetes, also featured the Sweet Escape: Hataw Galaw Intercollegiate Urban Dance Competition, a Zumba party, diabetes lay forums, exhibition booths, and games for people living with diabetes, families, advocacy and support groups, magazine readers and diabetes specialists.

GROWING NUMBERS
The World Health Organization (WHO) says diabetes is the fourth leading non-communicable disease in the world. Cardiovascular diseases top the list followed by cancer and respiratory diseases.

“We’re more afraid of dengue, HIV, Zika virus, and AIDS,” said Dr. Litonjua, “when many [more] people die of diabetes.”

According to the WHO data, 415 million people have diabetes worldwide. One third, or 150 million people, live in the West Pacific Region (WPR) which includes the Philippines and 20 other nations.

Over six million Filipinos have diabetes in the total population of more than 100 million, a disease prevalence of 6.1%. Projections say that by 2040, the numbers will swell by 215 million victims in the WPR area alone, and 12 million of these will live in the Philippines.

Worldwide, one person dies of diabetes every six seconds said Dr. Litonjua. He attributes the increasing number of diabetes victims to three “Ka”: katabaan (obesity), katakawan (gluttony); and katamaran (indolence).

Dr. Joy C. Fontanilla, editor in chief of DiabetEASE magazine and the head of the diabetes center of Asian Hospital and Medical Center, said those with a family history of diabetes, those who are overweight, the sedentary, smokers, and those who have hypertension are at greater risk. She suggests losing 5% to 7% of one’s body weight by doing at least 30 minutes of moderate exercise every day. Moderate, she says, is when you can still have a conversation but are too exhausted to sing a song.

Dr. Litonjua suggests that everyone — especially those who already have the disease and those on the borderline — exercise in cold places. When we exercise in a hot room, he said we only lose water, and gets the liquid back when we drink. But when we exercise in the cold, he said body fat burns easier.

And eat food rich in fiber and not in refined or white sugar.

source: Business World
http://www.weekender.bworldonline.com/2016/08/19/phl-is-losing-war-against-diabetes/

Corporate Social Responsibility expert shares ways to engage stakeholders in health research

PUERTO PRINCESA, PALAWAN- When asked how Unilab Foundation engages their stakeholders to support their advocacies, Ms. Rhodora Palomar-Fresnedi, Unilab Foundation Executive Director, emphasized the importance of “craft, curate, and communicate” during her presentation for the Health Research Communicators Meeting on 9 August 2016 at Citystate Asturias Hotel.

According to Fresnedi, knowing what story you want to tell is crucial in engaging stakeholders. In crafting a story, one should consider the possible reasons why people would want to hear a story. Likewise, one should be certain of the change that he/she wants his/her audience to make.

“You can’t build a community if no one can associate with your conflict,” Fresnedi emphasized. To connect with their audience, Fresnedi cited that all programs of Unilab Foundation are research-based.

To curate a story, Fresnedi advised to create a communication experience that will enable the people to become story tellers of their own.

“Kapag maganda ang istorya, if you build the experience, hindi niyo na kailangang mangimbita [ng mga tao], sila ang pupunta sayo,” she explained. The message becomes positive when people write from the heart, she added.

Another aspect to consider is communicating the message. In every research, the researcher should identify his/her target audience, ways to reach them, and means to measure his/her success on engaging them. The researcher should have robust communication, foundation, and structure, Fresnedi explained.

“Tell a story so compelling, others would want to write about it,” she ended.

The Health Research Communicators meeting is one of the pre-events of the 10^th Philippine National Health Research System (PNHRS) week celebration. With the theme “Research and Innovation for Health and the Environment,” the 10^th PNHRS Week provided a platform for interaction, learning, and collaboration of different stakeholders in health research and development. ■

Ethnic groups are not exempted from the consequences of changing environment

PUERTO PRINCESA, PALAWAN- “Ethnic groups worldwide are not exempted from the consequences of the changing environment,” thus emphasized during the session on Indigenous Health System and Environmental Pressures last 10th Philippine National Health Research System (PNHRS) Week celebration on 10 August 2016 at Citystate Asturias Hotel.

According to Dr. Jaime Montoya, PNHRS Lead Coordinator and Philippine Council for Health Research and Development (PCHRD) Executive Director, ethic groups are highly dependent on natural resources for survival. They are also vital in helping to improve the resilience of our ecosystem.

“[However] several environmental pressures such as habitat change, pollution, climate change and over-exploitation of resources greatly affect their way of life, especially their health,” he said.

Speakers of the session include Dr. Isidro Sia of Philippine Institute of Traditional and Alternative Health Care (PITAHC), Ms. April Grace Ortega-Liao of Palawan State University (PSU), Mr. Juanito Guarde of Department of Education-Naujan South District, and Atty. Erwin Caliba of the National Commission on Indigenous Peoples.

Sia discussed ways on “Building Resilient Indigenous People’s Health and Food Systems Through Agro-ecological Principles and Practices” through his introduction of the rich culture and biodiversity of the country and indigenous knowledge and practices of the IPs towards the environment.

“Ang pangangalaga sa kalikasan ay pangangalaga rin sa tao, sa buhay at sa kalusugan,” he emphasized.

Liao and Guarde shared their experiences on engaging with Tagbanua and Mangyan groups, respectively.

Liao discussed how Tagbanuas survived the changing environment through their health practices such as diday-diday, their habit of taking a break from working to protect their bodies. Likewise, Guarde, a Mangyan himself, stressed that they are happy and healthy people and contented with what they have.

Caliba talked about the rights of indigenous cultural communities as stated in the 1987 Philippine constitution, citing that ethic groups have rights to ancestral domains/lands, self-governance and empowerment, social justice, and cultural integrity. Likewise, he explained that all activities or researches to be done at the ancestral domain should have free and prior informed consent (FPIC).

PNHRS is an integrated national framework for health research which aims to promote cooperation and integration of all health research efforts and stakeholders in the country. For more information, visit its website at healthresearch.ph.