Thursday, September 8, 2011

A new risk marker for heart diseases

By Sharon See | Posted: 30 July 2011

A screening test that measures C-Reactive Protein levels in blood can be a more accurate indicator of possible heart diseases
SINGAPORE: Obesity, high cholesterol and smoking are some well-known factors that can lead to heart disease.

But there is another measure that can push a group of seemingly-healthy people into the high risk category.

Doctors said C-Reactive Protein (CRP) levels can be a more accurate indicator of possible heart diseases.

A screening test that measures CRP in blood can be a more accurate indicator, say doctors.

While such screening tests are not for everyone, those above the age of 40 who go for regular screening may benefit most.

Associate Professor Tai E Shyong, Senior Consultant & Head, Endocrinology, National University Hospital, said: "The Singapore recommendation is that everybody above the age of 40 should have a cholesterol measure, should have a blood pressure measure, should have a blood sugar measure.

"Then you can combine all these information to a score that tells you the chances of having a heart attack the next ten years is five per cent, 15 per cent, 20 per cent. That's the first thing you have to do. You got to do a risk assessment. What we're saying is that those people who're high risk, they need treatment.

"Those people at low risk probably don't need a drug, so there's no decision to be made. It's specifically the people who are in between 10 and 20 per cent. If you measure CRP, and the CRP is high, you might be a little bit more aggressive with drug therapy."

Cholesterol drugs or statins may now be prescribed for those at moderate risk but a high CRP.

Currently, doctors prescribe such drugs known as statins to those with heart disease or who are at high risk.

Studies by European researchers suggests their risk of stroke and heart attack can be cut by about 50 per cent.

However, there are side effects to statins, such as headache, muscle pain, abdominal pain, weakness and nausea.

For this reason, Associate Professor Tai said it is not cost effective for low risk individuals to take statins to lower the risk of heart disease as the side effects may outweigh the benefits.

But he added the best prevention is still to maintain a healthy lifestyle.

"One of the things that is important to remember is that lifestyle modification can bring down CRP. In fact, one of the most effective ways to do it is to lose weight. The other thing that's important is that, if you smoke, you got to stop smoking."

- CNA/fa

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A new risk marker for heart diseases

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Fat is more dangerous depending on ethnicity

Your genes, once again, benefitting, or destroying, you...

Posted: 29 July 2011

Picture of an obese male.
WASHINGTON - Weight gain can be more dangerous for South Asians than for Caucasians because the fat clings to organs like the liver instead of the skin, said a study published Thursday.

The main difference between Caucasians and South Asians comes down to how much space there is to store fat in the body and where it holes up, said Sonia Anand, lead author of the study in the public access journal PLoS One.

"South Asians have less space to store fat below the skin than white Caucasians," said Anand, a professor of medicine and epidemiology at McMaster University.

"Their excess fat, therefore, overflows to ectopic compartments, in the abdomen and liver where it may affect function."

When extra fats cling to the organs, it can cause high glucose and lipid levels, which are risk factors for heart disease.

That means South Asians with a weight and height ratio, or body mass index (BMI), that would be considered in the healthy range for Caucasians may merit screening for conditions like diabetes and coronary artery disease.

The Canada-based study recruited 108 people in all, some first- or second-generation immigrants from India, Pakistan, Sri Lanka, or Bangladesh and the rest Caucasian subjects whose ancestry could be traced to Europe.

They underwent a series of measurements and tests to assess body fat, cholesterol and sugar levels.

"Young, apparently healthy South Asians have greater metabolic impairment compared to white Caucasians who tend to develop metabolic changes at higher levels of obesity and at a more advanced age," said the study.

South Asians tended to have lower HDL (or good) cholesterol, higher total body fat but lower levels of abdominal fat, fattier livers and less lean muscle mass than Caucasians of similar age, height and weight.

"This study helps explain why South Asians experience weight-related health problems at lower BMI levels than Caucasians," said Arya Sharma, director of the Canadian Obesity Network and a co-author of the study.

"For the clinician, this also means that individuals of South Asian heritage need to be screened for the presence of heart disease and diabetes at lower BMIs."


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Fat is more dangerous depending on ethnicity

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Fewer breast cancer deaths not due to screening: study

Posted: 29 July 2011

PARIS - Mammograms have played an insignificant role in falling breast cancer death rates in Europe, according to a study published Friday.

Three pairs of countries with similar access to treatment but varying levels of breast screening showed scant difference in the degree of mortality attributed to the disease, researchers reported.

The study, published online by the British Medical Journal, adds to a growing body of evidence suggesting that two decades of routine screening has yielded modest results at best.

A trio of scientists led by Philippe Autier of the International Prevention Research Institute in Lyon, France compared the mortality rates of otherwise similar health systems that began screening programs at least a decade apart.

In Northern Ireland, which began systematic mammograms in the early 1990s, the death rate among breast cancer patients dropped 29 percent from 1989 to 2006. In Ireland, mortality went down nearly as much, 26 percent, over the same period even though the country didn't set up regular screening until 10 years later.

The Netherlands and Belgium also showed a parallel drop in breast cancer mortality rates -- identical in the case of Dutch-speaking Belgium -- despite a lag time of about a decade in the implementation of screening programmes.

And in Sweden, which in 1986 pioneered systematic mammograms to detect the disease, the drop was only 16 percent, compared to 24 percent in Norway, which began to do so only in 2005.

The slim difference in mortality rates suggests that the decrease was caused by other factors, such as better treatment, the researchers said.

"Since we began studying the long-term effects on mortality, a lot of data has suggested that the impact is little to none," Autier told AFP.

"I am among those who pushed hard for systematic screening for breast cancer in the 1990s," he added.

"But now there are question marks and we have to provide answers, because we cannot continue to promote something that may not be very effective but which can lead to a certain number of false positives," where healthy women are diagnosed as having the disease, he said.

Not all researchers agree that new data show screening to have been or marginal utility.

"The improvement in the prognosis of breast cancer patients is a multi-factor phenomenon," said Jerome Viguier, head of detection and screening at France's National Cancer Institute.

"It is very difficult to distinguish between different evolutions that are complementary and move in parallel," he told AFP by phone.

Viguier also emphasised that reducing mortality -- even if it is the overarching objective of screening -- is not the only impact.

"The aim is also to intervene earlier in the disease so that treatment is less invasive, with less mutilation, and fewer scares," he said.

He also questioned the premise of the new study that the health care systems compared were similar enough to single out systematic screening as the only significant difference.

Some experts argue that the difficult decision of whether to screen -- involving trade-offs among non-comparable outcomes -- must be left to informed individuals.

Others say that physicians should continue to encourage women to undergo regular screening because even modest benefits trump potentially negative impacts.


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Fewer breast cancer deaths not due to screening: study

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10 million illegal drug users have hepatitis C

Posted: 28 July 2011

A person is tested for Hepatitis C
PARIS: Some 10 million people who inject illegal drugs have hepatitis C while 1.2 million have hepatitis B, according to the first global estimate of infection rates among this population, published on Thursday.

Both viral diseases are debilitating and potentially deadly, and public health officials must step up efforts to combat blood-borne transmission and to lower treatment costs, the researchers urged.

The health and economic costs of hepatitis C (HCV) spread via injected drugs, on its own, may be as high or higher than for similarly transmitted cases of HIV, they said.

The study, published in the British journal The Lancet, found that fully two-thirds of the global population of "injecting drug users" have been exposed, and thus infected, to HVC.

About 80 percent are destined to develop chronic infections, and up to 11 percent of these individuals will, within two decades, suffer cirrhosis, which can cause liver failure and cancer.

There is currently no vaccine for the hepatitis C virus.

The portion of drug users with HCV - inferred from the presence of hepatitis C antibody - varied among the 77 countries from which data was collected.

The rate was 60 to 80 percent in 25 nations, including Spain (80 percent), Norway (76), Germany (75), France (74), the United States (73), China (67) and Canada (64).

In 12 countries, the percentage was higher than 80, including Italy, Portugal, Pakistan, The Netherlands, Thailand and Mexico, which had a 97 percent infection rate among mainlining drug users.

The United Kingdom, New Zealand and Australia had among the lowest percentage, just over half.

Hepatitis B virus (HBV) can be transmitted intravenously, as well as via sexual contact, and from mother to child.

There are 350 million people chronically infected worldwide, almost all of them exposed to the virus as children. "This is why universal infant vaccination against hepatitis B is so crucial to long term control of the virus," the authors note.

HBV is the second most important known human cancer-causing agent, after tobacco. The virus also causes cirrhosis and liver cancer, and is blamed for some 600,000 deaths each year, according to the World Health Organisation.

The study, led by Louisa Degenhardt of the Bernet Institute in Melbourne and Paul Nelson of the University of New South Wales, also in Australia, canvassed data from 59 countries on HBV rates among drug users who use needles.

Infection rates were five to 10 percent in 21 countries, and more than 10 percent in 10 countries, including the United States (12 percent).

Worldwide, the highest rates were in Vietnam (20 percent), Estonia (19), Saudi Arabia (18) and Taiwan (17).

The authors said high prices for medicine remains a major barrier to treatment of viral hepatitis, much as they have been in the past for HIV and AIDS.

"There are growing efforts to bring viral hepatitis treatments into the same lower cost access framework as antiretrovirals," they said, referring to the standard drugs used to hold HIV in check.

"But the significance of viral hepatitis needs to receive great attention than it does at present."

July 28 is World Hepatitis Day.

- AFP/de

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10 million illegal drug users have hepatitis C

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Measles kills over 1000 children in Congo

Posted: 26 July 2011

A DRC Ministry of Health employee administers a polio vaccination to a Congolese child in Lubumbashi in 2010 (AFP/File, Gwenn Dubourthoumieu)
KINSHASA - A measles epidemic has killed 1,145 children in the Democratic Republic of Congo since January, the UN's Humanitarian Affairs mission in Kinshasa said Monday.

The epidemic "has already affected 115,600 children and killed 1,145" between January and June, the UN Office for the Coordination of Humanitarian Affairs (OCHA) said in a statement.

This prompted the vaccination of 3.1 million children across five provinces, it added.

The campaign swung into action on May 10 after the NGO Doctors without Borders deplored "the lack of reactivity" of organisations like the World Health Organisation (WHO) to what it termed an "uncontrollable" epidemic.

Vaccination is continuing in two provinces, OCHA said.

Measles is extremely contagious and can cause severe diarrhoea, pneumonia and, in extreme cases, blindness and death.

It is one of the leading causes of death among young children globally, despite a safe vaccine being available.

In 2010, 5,407 cases were reported in DR Congo, leading to 82 deaths, up from 899 cases and 26 deaths the year before.

DR Congo is also battling cholera and polio epidemics that have claimed 250 people since March, and is the country with one of the world's highest child mortality rates -- 148 out of every 1,000 live births.

The WHO responded to OCHA criticism by calling for dialogue.

"If you have criticism, the best thing is to open dialogue to see what is not going well," its Kinshasa director Ayigan Kossi told AFP.


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Measles kills over 1000 children in Congo

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Chinese medicine could treat Parkinson's: HK study

Could it be that the Asians have it right all along, but just not so vocal about it...?

Posted: 22 July 2011

Chinese herbs
HONG KONG: Chinese medicine may be effective in battling certain symptoms of Parkinson's disease, and lessening side effects from the drugs used to treat the condition, according to a new study.

Researchers at Hong Kong Baptist University said Gouteng, a traditional Chinese herb used to treat hypertension, helped patients better communicate and made them less prone to depression and sleeping difficulties.

"There is no cure for Parkinson's right now, but the study showed Chinese medicine can help treat the disease," a university spokesman told AFP on Thursday.

Parkinson's is a progressive motor-system disorder which usually affects people over the age of 50, although it can strike earlier, often causing severe symptoms including body trembling, stiffness and loss of balance.

The condition is usually treated with a drug called levodopa, which the brain converts into dopamine to relieve the symptoms, but it can also cause nausea and hallucinations.

The Baptist University study found that patients who took Gouteng together with levodopa experienced fewer side effects from the drug while showing a marked improvement in their communication skills.

Li Min, an associate professor who led the study, said the findings could also help boost the profile of Chinese medicine.

"They provide not only pharmacological proof of the efficacy of Gouteng in treating Parkinson's disease, but will also help promote the effectiveness and safety of Chinese medicine to the international medical arena," she said.

Li - whose team has applied for a US patent - told the South China Morning Post that she expects the herb would start being used to treat the disease after the second phase of the study in 2013.

- AFP/al

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Chinese medicine could treat Parkinson's: HK study

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Sunday, September 4, 2011

WHO calls for ban on 'unreliable' TB blood tests

Posted: 21 July 2011

Blood tests
GENEVA: The World Health Organisation warned on Wednesday that millions of blood tests conducted every year to diagnose tuberculosis are unreliable and putting patients' lives in danger.

"Based on the evidence, (these) tests lead to misdiagnosis and mistreatment of patients. They are a waste of time and resources," Mario Raviglione, director of the WHO Stop TB Department, told reporters.

"We are calling on governments to ban the use of these tests."

An estimated two million such diagnostics, which look for antibodies or antigens in the blood, are used every year, and up to half of them could give false results, Karin Weyer, who works for the same department, said.

She warned that companies which continued to sell these diagnostic tools would be knowingly selling a faulty product.

"This is now a matter of public record," she said, adding however that the WHO did not know how many deaths resulted from these unreliable tests, which started being released in the 1990s.

They are mostly manufactured by companies based in the developed world, including Australia, Britain, Canada, France, Germany, Italy and the United States, but also in emerging giants China and India.

A list of companies pinpointed by the WHO includes US-based Mossman Associates, French group Anda Biologicals and British firm Omega Diagnostics.

"They cost the poor and vulnerable $10 to $30. And yet more often than not, the results are wrong," Raviglione said.

Other types of diagnostics, which cost between $16 and $28 give more reliable results, Raviglione said.

One of the reasons these tests are in the market is because of lack of regulations, Weyer explained.

"It's a multi-million dollar business centred on selling substandard tests with unreliable results.

"The market for these products is not in Europe or the US, but in developing countries.

"These companies just ship (the tests) to developing countries with weak or no regulatory framework," concluded Weyer.

According to the WHO website, there are some 9.4 million new cases of active TB and 1.7 million people who are killed by the transmissible disease every year.

- AFP/al

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WHO calls for ban on 'unreliable' TB blood tests

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Medical breakthroughs set to buoy AIDS war

Posted: 15 July 2011

A nurse draws blood from a patient for an HIV test
PARIS: The biggest medical forum on AIDS kicks off on Sunday to a buzz of excitement about potential strategies for curbing a pandemic that has now claimed 30 million lives in its three-decade history.

A four-day conference in Rome will mull dramatic evidence that drugs designed to treat patients with HIV can be used to shield uninfected people from the AIDS virus.

This could be the best news in 15 years, when antiretroviral drugs started to transform the human immunodeficiency virus (HIV) from a death sentence to a manageable disease.

It opens up dazzling options for rolling back a pandemic for which there is still no cure or vaccine, say some experts.

"Over the past 18 months, there has a been a string of good results from trials, and this has generated a fair bit of optimism," Jean-Francois Delfraissy, director of the French Agency for AIDS Research (ANRS), told AFP.

"Until recently, no one had found a medical way to prevent HIV - all there was, essentially, was the condom and the message of safe sex."

The conference will gather thousands of specialists, ranging from virologists to pharmacologists and disease trackers.

It is staged once every two years by the International AIDS Society (IAS), which also organises the International AIDS Conference, a bigger event that touches on the pandemic's many social dimensions.

Here are the main causes for all the excitement:

-- a trial conducted among "sero-discordant" heterosexual couples in Africa, meaning couples in which one partner had been tested positive HIV while the other was uninfected.

The risk of HIV infection fell by a whopping 96 percent when the infected partner started early use of daily antiretrovirals.

-- a trial conducted among sero-discordant heterosexual couples in Kenya and Uganda which took a quite different tack. It asked the uninfected partner to take the daily anti-HIV pill.

The risk of infection fell 62 to 73 percent compared with couples where the uninfected partner took a placebo.

"This is a major scientific breakthrough which reconfirms the essential role that antiretroviral medicine has to play in the AIDS response," Michel Sidibe, executive director of UNAIDS, said on Wednesday.

"These studies could help us to reach the tipping point in the HIV epidemic."

Some campaigners say "treatment as prevention" - treating infected people swiftly so that they do not infect others - should now spearhead the war on AIDS.

In 2009, more than 33 million people were living with HIV and 2.6 million people became newly infected, according to UNAIDS.

"If you start early treatment for people infected with HIV, you get a 96.3-percent decrease in transmission," Julio Montaner, director of the BC Centre for Excellence in HIV/AIDS in British Columbia, Canada, said in a phone interview.

"Nothing else has been shown that is as efficacious. And the cost benefit is triple, because it decreases morbidity, it decreases mortality and it decreases transmissions. I call it a hat-trick, you can't have it any better."

Now, though, comes the devil of detail, which will fully occupy the Rome conference.

Will the results from a trial - where volunteers are enthusiastic and encouraged by their partner to follow their pill regimen - be equally valid when extended to the messiness of real life?

And what about the risk that people become over-confident and forgo use of a condom?

Giving HIV pills to uninfected, as opposed to infected, people raises even more issues.

Antiretrovirals can cause toxic side effects and carry a potentially hefty cost if they have to be taken daily for prevention. The price has fallen to as little as 25 US cents per tablet, but this is still a big discouragement for people who are living on a couple of dollars a day or less.

IAS chief Bertrand Audoin said the prevention trials, combined with proof that male circumcision helps protect men from HIV, showed "we are in the middle of huge scientific breakthroughs that could change the course of the epidemic in coming years."

He cautioned, though: "One of the challenges we have to meet is to align the scientific evidence with policies implemented on the ground."

- AFP/al

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Medical breakthroughs set to buoy AIDS war

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New drug adds to arsenal against AIDS

Double-time against ADIS?

Posted: 15 July 2011

A container filled with an AIDS vaccine
PARIS: A new drug, rilpivirine, can add powerfully to the combination of medications used to control HIV for first-time patients, researchers conclude in Friday's issue of The Lancet.

Rilpivirine, marketed by pharmaceutical firm Tibotec under the brand name of Edurant, is both safe and effective and its side effects are fewer and less severe compared with the widely-used efavirenz, or Sustiva, they say.

Combination therapy for new HIV patients commonly entails giving either efavirenz or nevirapine in conjunction with drugs of a separate class in order to attack the human immunodeficiency virus (HIV) from different angles.

Efavirenz and nevirapine are equally effective at suppressing HIV but can cause severe side effects, which is why there has been a search for a substitute drug in their class.

The two studies report on data from two trials carried out among nearly 1,400 patients in 21 countries.

Rilpivirine, a so-called second generation antiretroviral, was approved for combination therapy in May by the US Food and Drug Administration (FDA).

The study appears in the runup to a four-day medical conference, starting in Rome on Sunday, on the state of the HIV/AIDS pandemic.

Acquired immune deficiency syndrome (AIDS) has claimed some 30 million lives since the first recorded cases emerged in June 1981. At least 33 million people are living with HIV, according to UN estimates for 2009.


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New drug adds to arsenal against AIDS

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HIV drugs boost prevention hopes

Posted: 14 July 2011

A woman at Nkosi's Haven, a shelter for destitute HIV-infected mothers and their children in Johannesburg, South Africa.
PARIS: Heterosexuals who take daily AIDS drugs reduce the risk of being infected by the human immunodeficiency virus (HIV) by nearly two-thirds, according to ground-breaking studies.

Campaigners hailed what they described as a powerful new weapon in the three-decade war against AIDS.

"This is a major scientific breakthrough which reconfirms the essential role that antiretroviral medicine has to play in the AIDS response," Michel Sidibe, executive director of the UN agency UNAIDS said.

"These studies could help us to reach the tipping point in the HIV epidemic."

A trial called Partners PrEP, conducted by the University of Washington, followed 4,758 "sero-discordant" heterosexual couples - in which one person had HIV and the other was uninfected - in Kenya and Uganda.

The uninfected partner received either a dummy pill or a tablet containing either the HIV drug tenofovir or a combination of tenofovir and emtricitabine.

In the group receiving tenofovir, there were 62 percent fewer infections compared with the placebo group.

In the tenofovir/emtricitabine group, there were 73 percent fewer infections over counterparts taking the placebo.

The results were so remarkable that safety monitors recommended the probe be stopped early, for to continue it would have been unethical.

The second trial, conducted by the US Centers for Disease Control and Prevention (CDC), followed 1,219 uninfected men and women in Botswana who received either placebo or the tenofovir/emtricitabine combination.

Those who received the antiretroviral pill reduced the risk of HIV infection by 63 percent compared with the placebo group.

They are the first trials to show that so-called pre-exposure prophylaxis, or PrEP, can work among heterosexuals.

Last November, a study conducted among sero-discordant homosexual men found a reduction of 44 percent in risk among uninfected partners who took HIV drugs.

In contrast, a smaller-scale trial, whose preliminary results were published earlier this year, found that PrEP did not protect heterosexual women.

In May, a big study conducted among sero-discordant heterosexual couples in Africa showed early use of drugs by the infected partner slashed the risk of transmitting HIV to the other partner by 96 percent.

Put together, these trials add massively to the argument that the world's AIDS pandemic can be slowed by wider distribution of antiretrovirals, said activists.

"These results are tremendously exciting and confirm that we are at pivotal period," said Mitchell Warren, executive director of US advocacy group AVAC.

"Now is the time to include ARV-based prevention in national plans, applications to the Global Fund to Fight AIDS, Tuberculosis and Malaria and donor priorities.

"... We need ambitious pilot and demonstration projects to guide programmatic design, along with national and international guidance on how best to use ARVs (antiretrovirals) as lifesaving prevention tools," he said.

The International AIDS Society, which is hosting a major conference in Rome from Sunday, said data from the two trials was "compelling" and "adds to the cascade of evidence".

But it also highlighted the looming debate about using drugs designed for treatment in the role of prevention.

Antiretrovirals are the famous "cocktail" of drugs, first introduced in 1996, that helped turn the tide against AIDS.

They suppress HIV in the body but do not eradicate it completely.

As a result, they reduce the risk of infection through contact with body fluids, although they are not a cure, and taking them can inflict toxic side effects.

In addition, there is a potentially hefty financial cost if the pills are taken daily for prevention, although the price has fallen to as little as 25 US cents per tablet.

The "treatment as prevention" strategy has risen alongside male circumcision as new options in the global HIV/AIDS pandemic, which has claimed around 30 million lives over the past three decades.

More than 33 million people are living with the AIDS virus, according to estimates for 2009 released last year by UNAIDS.

- AFP/al

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HIV drugs boost prevention hopes

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Spanish surgeons claim first double leg transplant

Posted: 12 July 2011

Spanish surgeon Pedro Cavadas
MADRID: Spanish surgeons on Monday performed the world's first double-leg transplant on a man whose legs were amputated above the knee after an accident, officials said.

Surgeons operated through the night on the man, who had faced life in a wheelchair because prosthetic limbs were unsuitable, said the health authority for the eastern region of Valencia.

"It is the first time in the world that such a transplant has been carried out," it said in a statement after the surgery, carried out in the La Fe hospital in the city of Valencia.

Neither donors nor the patient were identified but the health authority promised further details later this week.

Spain's health ministry announced in November that it had authorised a double leg transplant on an unidentified man who had both legs amputated above the knee after an accident.

The doctor in charge of the operation, Pedro Cavadas, is known in Spain for having carried out several transplants.

In October 2008, he carried out the first double arm transplant undertaken in Spain and the second in the world, while in August 2009 he performed the first face transplant in Spain.

Spanish Health Minister Leire Pajin on Monday telephoned Cavadas to congratulate him on the "success" of the latest operation, Spanish media reported.

The surgery "brings hope to other patients who have suffered amputations," the minister said.

She also praised the "generosity" of the donor's family who had helped "make our country an example of solidarity in the world."

Spain has become a world leader in organ donation since it set up a network of transplant coordinators in 1989 at all hospitals in the country which closely monitors emergency wards to identify potential donors.

- AFP/fa

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Spanish surgeons claim first double leg transplant

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First drug-resistant gonorrhea strain emerges

Are some diseases catching up with man's promiscuity?

Posted: 11 July 2011

OTTAWA : For the first time, international researchers have identified a strain of gonorrhea that is resistant to treatment with antibiotics, scientists announced at a sex disease research conference on Monday.

The common bacterial infection, often called the "clap", has until now been easily treatable with antibiotics but if left alone can cause infertility in women and painful urination and a pus-oozing infection in men.

"This is both an alarming and a predictable discovery," said Magnus Unemo of the Swedish Reference Laboratory for Pathogenic Neisseria.

"Since antibiotics became the standard treatment for gonorrhea in the 1940s, this bacterium has shown a remarkable capacity to develop resistance mechanisms to all drugs introduced to control it."

Details of the discovery were to be released by Unemo and colleagues at the 19th conference of the International Society for Sexually Transmitted Disease Research, from July 10-13 in Quebec City, Canada.

Since the finding is so new, scientists are unclear how widespread the resistant strain may be in the world population, but concerns are mounting that it could spread quickly.

"While it is still too early to assess if this new strain has become widespread, the history of newly emergent resistance in the bacterium suggests that it may spread rapidly unless new drugs and effective treatment programmes are developed," Unemo said.

As many as 700,000 people in the United States are believed to get gonorrhea annually, according to the Centers for Disease Control and Prevention.

Up to half of infected women experience no symptoms, while men usually see signs of infection within two to 30 days.

"Anyone who has any type of sex can catch gonorrhea," according to the US National Institutes of Health, which notes however that risks are higher among people with multiple partners and people who have unprotected sex.

"Gonorrhea is more common in large cities, inner-city areas, populations with lower overall levels of education and people with lower socio-economic status," added the NIH.

People who suspect they may be infected should see a doctor in order to obtain a prescription and should not attempt to treat the problem themselves, experts say.

The current treatment recommended by the CDC is an single dose pill of an antibiotic called cefixime, or a single dose of azithromycin (Zithromax) for people who are allergic to penicillin, ceftriaxone or cefixime.

Penicillin is no longer considered the standard treatment because it was previously found to be ineffective in some cases.

- AFP/al

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First drug-resistant gonorrhea strain emerges

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Robot cuts surgery time for stomach cancer patients in trial

Now this is 'local' to me, just around here...

By Vimita Mohandas | Posted: 06 July 2011

National University Hospital
SINGAPORE: It cuts surgery time for stomach cancer patients to 17 minutes from eight hours, does away with the need for hospitalisation and allows patients to undergo surgery without having to bear scars.

Called MASTER (Master and Slave Transluminal Endoscopic Robot), the new procedure was jointly developed by the Nanyang Technological University (NTU) and the National University Hospital (NUH) after six years of research.

Three patients from India were the first to benefit from the flexible endoscopy technology - possibly a world-first to be performed on stomach cancer patients, said Singapore doctors.

The procedure uses a flexible endoscope or tube with small robotic arms inserted through the mouth, with the surgeon monitoring on a computer screen.

Using joystick and buttons, the surgeon controls the robotic arms to remove the cancerous tumour in the stomach.

The robotic arms, which are up to 6mm in diameter, can also feel the tissues of the stomach and intestines, helping surgeons vary the pressure.

Associate Professor Louis Phee, head of the Division of Mechatronics and Design at NTU, said: "With this robotic system, you're giving a lot of manoeuvrability and dexterity to the endoscopist such that he can act and perform like a surgeon. He'll be able to manipulate tissues, he'll be able to cut and in the near future, he will also be able to suture, which means he can actually sew inside, and that will be great for sewing up wounds inside the stomach."

While the gadget has reaped benefits during its trial stages, experts say there is still room for fine-tuning.

Professor Ho Khek Yu, senior consultant at the Department of Gastroenterology and Hepatology at NUH, said: "Currently, we can only do procedures on early stomach tumours because the robotic arms are fashioned to do this procedure only. This procedure is challenging and needs a certain period of training. We need to adapt the robotic arms further to allow us to do more complicated procedures such as obesity surgery and anti-reflux surgery in future."

Experts hope to see the procedure used in hospitals in about three years. - TODAY

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Robot cuts surgery time for stomach cancer patients in trial

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